Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 15012 | Date 28/10/2026 |
| Token No | SM/25-26/6118 28/10/2026 | Serial | 038 |
| Patient Name | Miss KATHA SANTRA | Contact No | 9230672556 |
| Address | 636 G.T. ROAD | Age | 24 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||