Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 06840 | Date 29/08/2022 |
| Token No | SM/25-26/1225 15/07/2025 | Serial | 006 |
| Patient Name | Mrs. SUSHILA KHATIK | Contact No | NOT GIVEN |
| Address | 79 DEY STREET | Age | 63 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||