Ticket for Outdoor Patient
| Ward No. 25 | U-PHC No. | Registration No. 13792 | Date 27/11/2025 |
| Token No | SM/25-26/2801 27/11/2025 | Serial | 017 |
| Patient Name | Mrs. ARATI DAS | Contact No | 8777375345 |
| Address | 3/174 MAHESH COLONY | Age | 44 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||