Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 12356 | Date 20/11/2024 |
| Token No | SM/25-26/1549 06/08/2025 | Serial | 010 |
| Patient Name | Mrs. RAJIA BIBI | Contact No | NOT GIVEN |
| Address | 1 DEY GHAT LANE | Age | 66 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||