Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 13186 | Date 30/06/2025 |
| Token No | SM/25-26/1032 30/06/2025 | Serial | 017 |
| Patient Name | Miss PUNAM SHARMA | Contact No | 6289214973 |
| Address | CHOTO BELU SARDAR PARA | Age | 17+ YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||