Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 08604 | Date 21/03/2023 |
| Token No | SM/25-26/2464 31/10/2025 | Serial | 008 |
| Patient Name | Mrs. LALMUNI DEBI | Contact No | 8981625423 |
| Address | 1 DEY GHAT LANE | Age | 57 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||