Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 13176 | Date 26/06/2025 |
| Token No | SM/25-26/998 26/06/2025 | Serial | 018 |
| Patient Name | Mrs. KANIKA SAMANTA | Contact No | NOT GIVEN |
| Address | NALIKUL | Age | 50 Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||