Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 11570 | Date 25/05/2024 |
| Token No | SM/25-26/2404 28/10/2025 | Serial | 001 |
| Patient Name | Mrs. RUMA SIMLAI | Contact No | 9748993153 |
| Address | 166/A/1 THAKUR BATI STREET | Age | 57 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||