Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13214 | Date 08/07/2025 |
| Token No | SM/25-26/1127 08/07/2025 | Serial | 004 |
| Patient Name | Mrs. KRISHNA DEBI | Contact No | 7549814490 |
| Address | 3/A PITAMBAR DEY LANE | Age | 50 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||