Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 08471 | Date 28/02/2023 |
| Token No | SM/25-26/1926 06/09/2025 | Serial | 014 |
| Patient Name | Miss KAJAL KUMARI | Contact No | |
| Address | 78 dey street | Age | 28 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||