Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 12125 | Date 21/09/2024 |
| Token No | SM/25-26/796 12/06/2025 | Serial | 021 |
| Patient Name | Mrs. KEYA BHAR DAS | Contact No | 9051223992 |
| Address | 40 NABAKRISHNA GUIN LANE | Age | 34 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||