Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 10035 | Date 09/10/2025 |
| Token No | SM/25-26/11009 26/11/2025 | Serial | 003 |
| Patient Name | Mrs. SABITA PALEI | Contact No | 9163172537 |
| Address | 167 NEW MAHESH SERAMPORE 712203 | Age | 55 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||