Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13600 | Date 11/10/2025 |
| Token No | SM/25-26/2258 11/10/2025 | Serial | 013 |
| Patient Name | Mrs. URMILA DAS | Contact No | 6289750522 |
| Address | 14/C DEY STREET | Age | 60 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||