Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13256 | Date 21/07/2025 |
| Token No | SM/25-26/1295 21/07/2025 | Serial | 004 |
| Patient Name | Mrs. CHANDRABATI DEBI | Contact No | 8961994711 |
| Address | 8/4 RAM SITA LANE | Age | 57 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||