Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13405 | Date 19/08/2025 |
| Token No | SM/25-26/1720 19/08/2025 | Serial | 004 |
| Patient Name | Mrs. SABHASHREE SRIMANI | Contact No | 7980101538 |
| Address | 114 THAKURBATI STREET | Age | 32 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||