Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 10909 | Date 09/12/2023 |
| Token No | SM/25-26/696 09/06/2025 | Serial | 012 |
| Patient Name | Mrs. SARBANI CHAKRABORTY | Contact No | 7003859278 |
| Address | 15 BROJO DUTTA LANED | Age | 37 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||