Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 13299 | Date 26/07/2025 |
| Token No | SM/25-26/1403 26/07/2025 | Serial | 004 |
| Patient Name | Mrs. KAMLI DEBI PASWAN | Contact No | 8100064003 |
| Address | 16/T SITAL SARKAR LANE | Age | 49 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||