Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09648 | Date 28/07/2025 |
| Token No | SM/25-26/10410 14/11/2025 | Serial | 022 |
| Patient Name | Mrs. RIMA BHATTACHARYA | Contact No | 7044134502 |
| Address | KANTARIA KATARI KHIGRAM KATWA I PURBA BARDHAMAN | Age | 31 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||