Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 13879 | Date 19/12/2025 |
| Token No | SM/25-26/3047 19/12/2025 | Serial | 003 |
| Patient Name | Mrs. TRISHNA MONDAL | Contact No | 9433576503 |
| Address | 114 PATUAPARA LANE | Age | 61 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||