Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 11670 | Date 18/06/2024 |
| Token No | SM/25-26/2864 03/12/2025 | Serial | 013 |
| Patient Name | Mrs. PUJA DEBI | Contact No | 8910360960 |
| Address | 7 dey ghat lane | Age | 30 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||