Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 11506 | Date 09/05/2024 |
| Token No | SM/25-26/839 16/06/2025 | Serial | 004 |
| Patient Name | Mrs. SOMA PAL | Contact No | 9073306291 |
| Address | 67 THAKUR BATI STREET | Age | 35 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||