Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 06941 | Date 06/09/2022 |
| Token No | SM/24-25/21243 08/03/2025 | Serial | 002 |
| Patient Name | Mrs. SIKHA DAS | Contact No | |
| Address | 28 khasbagan lane | Age | 45 yrs Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||