Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 12516 | Date 10/01/2025 |
| Token No | SM/25-26/681 06/06/2025 | Serial | 001 |
| Patient Name | Mrs. RIMPI BASAK | Contact No | 8777599574 |
| Address | 122 R.B. SARANI | Age | 19 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||