Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 10232 | Date 27/11/2025 |
| Token No | SM/25-26/12461 29/12/2025 | Serial | 030 |
| Patient Name | Mrs. RUPA AICH | Contact No | 6291646069 |
| Address | SHEORAPHULI | Age | 42 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||