Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 13487 | Date 08/09/2025 |
| Token No | SM/25-26/2559 10/11/2025 | Serial | 011 |
| Patient Name | Mrs. SANTOSHI SHAW | Contact No | 6290371731 |
| Address | 40B/ 1 BLC MILL ROAD | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||