Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 12413 | Date 02/12/2024 |
| Token No | SM/25-26/1062 02/07/2025 | Serial | 015 |
| Patient Name | Mrs. TANIA BRAMHA (NAHA) | Contact No | 9123938191 |
| Address | 24/1 DEY BAGAN LANE | Age | 23 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||