Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13678 | Date 31/10/2025 |
| Token No | SM/25-26/2457 31/10/2025 | Serial | 001 |
| Patient Name | Mrs. LAXMI KANTA | Contact No | 6290913860 |
| Address | 9 NO LINE | Age | 80 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||