Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13420 | Date 28/08/2025 |
| Token No | SM/25-26/2213 09/10/2025 | Serial | 014 |
| Patient Name | Mrs. KIRAN KUMARI | Contact No | 9939735258 |
| Address | LOCAL, 99 THAKURBATI STREET | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||