Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 13537 | Date 18/09/2025 |
| Token No | SM/25-26/2104 18/09/2025 | Serial | 027 |
| Patient Name | Mrs. SOMA HALDER | Contact No | 7439282805 |
| Address | 20 PATUAPARA | Age | 45 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||