Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13756 | Date 20/11/2025 |
| Token No | SM/25-26/2694 20/11/2025 | Serial | 008 |
| Patient Name | Mrs. MAMANI BAR | Contact No | 7439541806 |
| Address | 39/A S.B. GHOSH LANE | Age | 41 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||