Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 11712 | Date 27/06/2024 |
| Token No | SM/25-26/2479 03/11/2025 | Serial | 015 |
| Patient Name | Mrs. BASANTI GHORUI | Contact No | 9088535437 |
| Address | 11A BARAL BAGAN LANE | Age | 48 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||