Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 10756 | Date 08/11/2023 |
| Token No | SM/25-26/2026 12/09/2025 | Serial | 012 |
| Patient Name | Mrs. ABHA SRIMANI | Contact No | 8902755606 |
| Address | 6B BECHU DEY LANE | Age | 72 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||