Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13654 | Date 25/10/2025 |
| Token No | SM/25-26/2384 25/10/2025 | Serial | 006 |
| Patient Name | Mrs. SUNITA SHAW | Contact No | 6290014255 |
| Address | 55 RAILAND ROAD | Age | 46 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||