Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13233 | Date 15/07/2025 |
| Token No | SM/25-26/1224 15/07/2025 | Serial | 005 |
| Patient Name | Miss ALKA KUMARI RAJBHAR | Contact No | 9007591910 |
| Address | 79 DEY STREET | Age | 25 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||