Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00961 | Date 25/09/2018 |
| Token No | SM/24-25/20914 11/02/2025 | Serial | 002 |
| Patient Name | Mrs. RAMAWATI DEVI | Contact No | 8697588467 |
| Address | 7 NO DEY GHAT LANE | Age | 65 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||