Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04902 | Date 13/09/2021 |
| Token No | SM/25-26/2031 12/09/2025 | Serial | 017 |
| Patient Name | Mrs. BIDYA DEBI | Contact No | 8902004551 |
| Address | 10 DEY GHAT LANE | Age | 70 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||