Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 12921 | Date 24/04/2025 |
| Token No | SM/25-26/1967 09/09/2025 | Serial | 010 |
| Patient Name | Mrs. BINA KOSTA | Contact No | 8478882085 |
| Address | 19 BLC MILLS ROAD | Age | 64 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||