Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 13383 | Date 14/08/2025 |
| Token No | SM/25-26/2634 14/11/2025 | Serial | 011 |
| Patient Name | Mrs. RUSMITA DAS | Contact No | 6290689702 |
| Address | 29/C PATUA PARA LANE | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||