Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 12588 | Date 29/01/2025 |
| Token No | SM/24-25/21099 24/02/2025 | Serial | 019 |
| Patient Name | Mrs. SUMAN KUMARI RAM | Contact No | 8910961670 |
| Address | 4 NO DEY GHAT LANE | Age | 21 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||