Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 09675 | Date 30/07/2025 |
| Token No | SM/25-26/5620 31/07/2025 | Serial | 021 |
| Patient Name | Mrs. SUPRIYA MANNA | Contact No | 8100345746 |
| Address | 21/22 BHATTACHARYA GARDEN BYE LANE NABAGRAM BAIDYABATI M 712203 | Age | 29 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||