Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13675 | Date 30/10/2025 |
| Token No | SM/25-26/2510 04/11/2025 | Serial | 007 |
| Patient Name | Mrs. ISHA MAHATO | Contact No | 8100504535 |
| Address | 21 NO BARAL BAGAN | Age | 34 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||