Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10066 | Date 15/10/2025 |
| Token No | SM/25-26/9177 15/10/2025 | Serial | 066 |
| Patient Name | Mrs. KAMALA DAS | Contact No | 8100493556 |
| Address | GHORAMARA SERAMPORE 712249 | Age | 60 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||