Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13767 | Date 24/11/2025 |
| Token No | SM/25-26/2717 24/11/2025 | Serial | 004 |
| Patient Name | Mrs. ANJALI DAS | Contact No | 9875520689 |
| Address | 109 THAKURBATI STREET | Age | 65 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||