Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13533 | Date 18/09/2025 |
| Token No | SM/25-26/2093 18/09/2025 | Serial | 016 |
| Patient Name | Mrs. SOBHA DEVI KOIRI | Contact No | 7278869737 |
| Address | 79 DEY STREET | Age | 55 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||