Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13571 | Date 08/10/2025 |
| Token No | SM/25-26/2190 08/10/2025 | Serial | 009 |
| Patient Name | Mrs. KUNTI JANA | Contact No | 8420853695 |
| Address | 9/496 COKREN ROAD | Age | 61 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||