Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 14999 | Date 28/10/2026 |
| Token No | SM/25-26/6105 28/10/2026 | Serial | 025 |
| Patient Name | Mrs. SUMANA CHANDRA | Contact No | 8073198390 |
| Address | 76/B/1 R.B. SARANI | Age | 35 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||