Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13179 | Date 30/06/2025 |
| Token No | SM/25-26/1019 30/06/2025 | Serial | 004 |
| Patient Name | Mrs. SASHI JENNA | Contact No | 8961338452 |
| Address | DEY STREET | Age | 65 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||