Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12609 | Date 31/01/2025 |
| Token No | SM/25-26/1188 12/07/2025 | Serial | 001 |
| Patient Name | Mrs. SIMA DEBI | Contact No | 9262969783 |
| Address | RAM SITA LANE, 9 NO INDIA JUTE MILL | Age | 30 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||