Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 12141 | Date 24/09/2024 |
| Token No | SM/25-26/185 21/04/2025 | Serial | 030 |
| Patient Name | Mrs. PUSHPA KUMARI SHAW | Contact No | 7003802976 |
| Address | 32B BARAL BAGAN LANE | Age | 28 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||