Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13094 | Date 11/06/2025 |
| Token No | SM/25-26/742 11/06/2025 | Serial | 005 |
| Patient Name | Mrs. SANGITA RAKSHIT | Contact No | 7003009563 |
| Address | 69/A BHAGIRATHI LANE | Age | 31 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||