Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 11031 | Date 10/01/2024 |
| Token No | SM/24-25/20782 30/01/2025 | Serial | 005 |
| Patient Name | Mrs. PUJA DEVI | Contact No | 9062897184 |
| Address | 6 NAYA BAGAN | Age | 20 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||