Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 10985 | Date 20/12/2023 |
| Token No | SM/25-26/1298 21/07/2025 | Serial | 007 |
| Patient Name | Miss PURNIMA SETH | Contact No | 9051561078 |
| Address | JOLKOL WORKER | Age | 40 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||