Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13399 | Date 18/08/2025 |
| Token No | SM/25-26/1707 18/08/2025 | Serial | 007 |
| Patient Name | Mrs. BELI RAJBHAR | Contact No | 7044108402 |
| Address | 3 PITAMBAR DEY LANE | Age | 75 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||