Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13409 | Date 26/08/2025 |
| Token No | SM/25-26/1734 26/08/2025 | Serial | 001 |
| Patient Name | Mrs. SWAPNA DAS | Contact No | 6291767066 |
| Address | 95 THAKUR BATI STREET | Age | 61 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||