Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 04663 | Date 27/07/2021 |
| Token No | SM/24-25/20572 17/01/2025 | Serial | 022 |
| Patient Name | Mrs. CHAMPA NATH | Contact No | 6294088040 |
| Address | 48 KHASBAGAN | Age | 26 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||