Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 08355 | Date 16/02/2023 |
| Token No | SM/25-26/780 12/06/2025 | Serial | 005 |
| Patient Name | Mrs. GAYETRI MUKHERJEE | Contact No | 8017656012 |
| Address | 514B G T ROAD | Age | 62 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||