Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 12538 | Date 16/01/2025 |
| Token No | SM/25-26/1196 12/07/2025 | Serial | 009 |
| Patient Name | Mrs. TUKTUKI DAS | Contact No | 7031477318 |
| Address | 72/G PATUAPARA LANE | Age | 30 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||