Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12820 | Date 22/03/2025 |
| Token No | SM/24-25/21435 22/03/2025 | Serial | 001 |
| Patient Name | Mrs. KM JYOTI | Contact No | 8858154970 |
| Address | 31/B DR. N.L. B. STREET | Age | 22 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||