Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 12761 | Date 12/03/2025 |
| Token No | SM/24-25/21288 12/03/2025 | Serial | 004 |
| Patient Name | Mrs. KALABATI SHAW | Contact No | |
| Address | 9 DOSTI LANE | Age | 62 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||