Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13153 | Date 25/06/2025 |
| Token No | SM/25-26/963 25/06/2025 | Serial | 017 |
| Patient Name | Mrs. SIBANI NATH. | Contact No | 9831132602 |
| Address | 18/B/1 KAILASH CHATTERJEE LANE | Age | 30 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||