Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13161 | Date 25/06/2025 |
| Token No | SM/25-26/975 25/06/2025 | Serial | 029 |
| Patient Name | Mrs. SARASWATI SHAW | Contact No | 9007592822 |
| Address | 72/A POTUA PARA | Age | 58 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||