Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 14819 | Date 29/08/2026 |
| Token No | SM/25-26/5623 29/08/2026 | Serial | 007 |
| Patient Name | Mrs. RUMA GARAI | Contact No | 9073784882 |
| Address | 106 1/B J N LAHIRI ROAD | Age | 37 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||