Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13226 | Date 11/07/2025 |
| Token No | SM/25-26/1182 11/07/2025 | Serial | 015 |
| Patient Name | Mrs. BASANTI DEVI | Contact No | 9123750538 |
| Address | 14B DEY STREET | Age | 45 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||