Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 13637 | Date 18/10/2025 |
| Token No | SM/25-26/2339 18/10/2025 | Serial | 012 |
| Patient Name | Mrs. SUNITA SINGH | Contact No | 9836343084 |
| Address | TETULTALA, BAIDYABATI (M) | Age | 40 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||