Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04662 | Date 27/07/2021 |
| Token No | SM/24-25/20573 17/01/2025 | Serial | 023 |
| Patient Name | Mrs. RUBI DEBI | Contact No | NOT GIVEN |
| Address | 7 NO GATE, INDIA JUTE MILL | Age | 28 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||