Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02469 | Date 11/07/2019 |
| Token No | SM/25-26/999 26/06/2025 | Serial | 019 |
| Patient Name | Mrs. PRIYANKA RAJBHAR | Contact No | 9804021813 |
| Address | 16 KAILASH CHATTERJEE LANE | Age | 25 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||