Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13063 | Date 31/05/2025 |
| Token No | SM/25-26/2116 19/09/2025 | Serial | 005 |
| Patient Name | Mrs. SHARMALIKA CHONGDER | Contact No | 8777522147 |
| Address | 4 G T ROAD | Age | 36 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||