Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13543 | Date 19/09/2025 |
| Token No | SM/25-26/2115 19/09/2025 | Serial | 004 |
| Patient Name | Mrs. MAMATA BISWAL | Contact No | 8420489009 |
| Address | 44B/1 DR. N.L. BHATTACHARYA STREET | Age | 33 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||