Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 09299 | Date 15/05/2025 |
| Token No | SM/25-26/8898 10/10/2025 | Serial | 014 |
| Patient Name | Mrs. SUMAN ROY | Contact No | 8617795604 |
| Address | 14/1 BAGPARA 8TH LANE MOREPUKUR RISHRA M 712250 | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | 100/60 mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||