Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10172 | Date 14/11/2025 |
| Token No | SM/25-26/10421 14/11/2025 | Serial | 033 |
| Patient Name | Mrs. SONALI RAM | Contact No | |
| Address | SERAMPORE | Age | 19 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||