Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 12746 | Date 08/03/2025 |
| Token No | SM/24-25/21245 08/03/2025 | Serial | 004 |
| Patient Name | Mrs. SOM RAM | Contact No | 9674884921 |
| Address | 16 KAILASH CHATTERJEE LANE | Age | 45 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||