Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12824 | Date 24/03/2025 |
| Token No | SM/25-26/1508 01/08/2025 | Serial | 002 |
| Patient Name | Mrs. RITA DEVI | Contact No | 9801435934 |
| Address | 14/C DEY STREET | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||