Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 12129 | Date 23/09/2024 |
| Token No | SM/25-26/1538 05/08/2025 | Serial | 012 |
| Patient Name | Mrs. RAMAWATI DEBI | Contact No | 7985262545 |
| Address | 7 DEY GHAT LANE | Age | 70 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||