Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 07932 | Date 21/09/2024 |
| Token No | SM/25-26/9328 17/10/2025 | Serial | 030 |
| Patient Name | Mrs. SHYAMALI GHOSH | Contact No | 9836428238 |
| Address | 147 BAIDYABATI M 712222 | Age | 58 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||