Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 12812 | Date 19/03/2025 |
| Token No | SM/25-26/216 23/04/2025 | Serial | 027 |
| Patient Name | Mrs. BRISTI MONDAL | Contact No | 6291072819 |
| Address | MILL ROAD | Age | 24 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||