Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13108 | Date 12/06/2025 |
| Token No | SM/25-26/799 12/06/2025 | Serial | 024 |
| Patient Name | Mrs. PUSPANJALI SHAU | Contact No | 8478087470 |
| Address | 97 N.L. BHATTACHAJEE STREET | Age | 33 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||