Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 13749 | Date 18/11/2025 |
| Token No | SM/25-26/2672 18/11/2025 | Serial | 011 |
| Patient Name | Mrs. SHRABANTI SEN | Contact No | 8282857462 |
| Address | CHATRA BAGER BAGAN | Age | 37 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||