Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 13611 | Date 13/10/2025 |
| Token No | SM/25-26/2276 13/10/2025 | Serial | 012 |
| Patient Name | Mrs. ANITA SHAW | Contact No | 9748066905 |
| Address | MANIKTALA DEY BAGAN | Age | 45 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||