Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 12662 | Date 13/02/2025 |
| Token No | SM/25-26/1539 05/08/2025 | Serial | 013 |
| Patient Name | Mrs. JAYOTI KUMARI | Contact No | 9062887932 |
| Address | 102 J.N.LAHIRI ROAD | Age | 25 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||