Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 13581 | Date 09/10/2025 |
| Token No | SM/25-26/2208 09/10/2025 | Serial | 009 |
| Patient Name | Mrs. SONAM SHAW | Contact No | 8617773690 |
| Address | 3/A SITAL SARKAR LANE | Age | 22 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||