Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13708 | Date 06/11/2025 |
| Token No | SM/25-26/2538 06/11/2025 | Serial | 017 |
| Patient Name | Mrs. GURIYA DEBI | Contact No | 9132903953 |
| Address | 10 DEY STREET | Age | 35 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||