Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 09819 | Date 01/08/2023 |
| Token No | SM/25-26/2650 17/11/2025 | Serial | 014 |
| Patient Name | Mrs. MINA DEBI | Contact No | 9143236552 |
| Address | PACHU BAZAR | Age | 62 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||