Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06270 | Date 04/07/2022 |
| Token No | SM/25-26/778 12/06/2025 | Serial | 003 |
| Patient Name | Mrs. TAMALI CHAKRABORTY | Contact No | 8697264725 |
| Address | NALIKUL | Age | 56 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||