Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 11506 | Date 09/05/2024 |
| Token No | SM/25-26/6074 27/10/2026 | Serial | 003 |
| Patient Name | Mrs. SOMA PAL | Contact No | 9073306291 |
| Address | 67 THAKUR BATI STREET | Age | 37 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||