Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13651 | Date 25/10/2025 |
| Token No | SM/25-26/5599 27/08/2026 | Serial | 005 |
| Patient Name | Mrs. ANNAPURNA PAL | Contact No | 9330625068 |
| Address | 11 A THAKURBATI STREET | Age | 60 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||