Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13618 | Date 15/10/2025 |
| Token No | SM/25-26/2759 25/11/2025 | Serial | 012 |
| Patient Name | Mrs. ANJALI DEVI | Contact No | 9883601559 |
| Address | LALIT MOHON BHATTACHARYA STREET | Age | 22 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||