Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13056 | Date 26/05/2025 |
| Token No | SM/25-26/600 26/05/2025 | Serial | 008 |
| Patient Name | Mrs. KOSHILA DAS | Contact No | 9674618353 |
| Address | KALITALA KATAPOL | Age | 50 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||