Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 11824 | Date 20/07/2024 |
| Token No | SM/25-26/747 11/06/2025 | Serial | 010 |
| Patient Name | Mrs. ALPANA ROY | Contact No | 6289238831 |
| Address | 67B JITEN LAHIRI ROAD | Age | 34 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||