Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 12505 | Date 06/01/2025 |
| Token No | SM/25-26/2071 16/09/2025 | Serial | 001 |
| Patient Name | Mrs. PARBATI HELA | Contact No | 8961298536 |
| Address | 12/566 COCKREN ROAD | Age | 23 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||