Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 13722 | Date 12/11/2025 |
| Token No | SM/25-26/2580 12/11/2025 | Serial | 007 |
| Patient Name | Mrs. MANA PAL | Contact No | 8583047723 |
| Address | 112D N N COLONY | Age | 57 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||