Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12720 | Date 03/03/2025 |
| Token No | SM/24-25/21163 03/03/2025 | Serial | 024 |
| Patient Name | Mrs. DIPA DEVI | Contact No | 7439700494 |
| Address | 9 NO NOYA BAGAN | Age | 25 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||