Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13497 | Date 09/09/2025 |
| Token No | SM/25-26/1971 09/09/2025 | Serial | 014 |
| Patient Name | Mrs. SUKMARI DEBI | Contact No | NOT GIVEN |
| Address | AKHNA PARA DEY STREET | Age | 70 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||