Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 04239 | Date 05/04/2021 |
| Token No | SM/25-26/650 04/06/2025 | Serial | 015 |
| Patient Name | Mrs. SANDHYA ROY | Contact No | 9875699744 |
| Address | 90 PATUA PARA LANE | Age | 39 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||