Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 09869 | Date 04/08/2023 |
| Token No | SM/25-26/1021 30/06/2025 | Serial | 006 |
| Patient Name | Mrs. DURGA DAS | Contact No | 6290021070 |
| Address | PACHU BAZAR | Age | 32 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||