Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 13596 | Date 11/10/2025 |
| Token No | SM/25-26/2250 11/10/2025 | Serial | 005 |
| Patient Name | Mrs. RITA DEVI | Contact No | 9088863523 |
| Address | J.N. LAHIRI ROAD | Age | 40 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||