Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 11305 | Date 21/03/2024 |
| Token No | SM/25-26/836 16/06/2025 | Serial | 001 |
| Patient Name | Mrs. TULI DEY | Contact No | 9477502081 |
| Address | 5E GOPAL GANGULY LANE | Age | 40 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||