Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09647 | Date 28/07/2025 |
| Token No | SM/25-26/5439 28/07/2025 | Serial | 034 |
| Patient Name | Mrs. SHAKUNTI DEVI | Contact No | 6202920686 |
| Address | GHORAMARA P SERAMPORE 712249 | Age | 39 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||