Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13626 | Date 15/10/2025 |
| Token No | SM/25-26/2308 15/10/2025 | Serial | 019 |
| Patient Name | Mrs. MANJU DEVI. | Contact No | 9062375128 |
| Address | 1 NO INDIA JUTE MILL | Age | 47 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||