Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12647 | Date 12/02/2025 |
| Token No | SM/24-25/20926 12/02/2025 | Serial | 011 |
| Patient Name | Mrs. LACHHMI DEVI | Contact No | 6291515424 |
| Address | RFAM SITA LANE, NAYA BAGAN | Age | 27 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||