Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 13524 | Date 15/09/2025 |
| Token No | SM/25-26/2054 15/09/2025 | Serial | 011 |
| Patient Name | Mrs. PRIYANKA RAJBHAR | Contact No | 6289951025 |
| Address | NATUNGRAM RAMKRISHNA PALLY | Age | 21 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||