Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 13397 | Date 18/08/2025 |
| Token No | SM/25-26/1705 18/08/2025 | Serial | 005 |
| Patient Name | Mrs. B ANKITA | Contact No | 8981343478 |
| Address | 35 J.N. LAHIRI ROAD | Age | 20 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||