Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 12892 | Date 21/04/2025 |
| Token No | SM/25-26/160 21/04/2025 | Serial | 005 |
| Patient Name | Mrs. UMRAWATI DEBI | Contact No | 9681820670 |
| Address | 18 NO JHAUTALA | Age | 70 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||