Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05252 | Date 07/01/2022 |
| Token No | SM/25-26/1393 25/07/2025 | Serial | 006 |
| Patient Name | Mrs. ANITA DEBI.. | Contact No | 9831432883 |
| Address | 6/A PANCHANAN TALA | Age | 53 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||