Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13216 | Date 09/07/2025 |
| Token No | SM/25-26/1136 09/07/2025 | Serial | 007 |
| Patient Name | Mrs. SUJATA MALLICK. | Contact No | 8777654034 |
| Address | 12 PTAMBAR DEY LANE | Age | 35 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||