Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 13759 | Date 21/11/2025 |
| Token No | SM/25-26/2700 21/11/2025 | Serial | 004 |
| Patient Name | Mrs. JHUMA DEY | Contact No | 9874821553 |
| Address | 36/A KHASBAGAN LANE | Age | 38 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||