Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 12004 | Date 28/08/2024 |
| Token No | SM/25-26/2632 14/11/2025 | Serial | 009 |
| Patient Name | Mrs. PUSPA KUMARI SHAW | Contact No | 9123044241 |
| Address | 39 DEY STREET | Age | 26 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||