Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12536 | Date 16/01/2025 |
| Token No | SM/24-25/20540 16/01/2025 | Serial | 017 |
| Patient Name | Mrs. KAREENA DEVI SHAW | Contact No | 7005897840 |
| Address | INDIA JUTE MILL | Age | 24 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||