Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 13830 | Date 05/12/2025 |
| Token No | SM/25-26/2895 05/12/2025 | Serial | 009 |
| Patient Name | Mrs. LACHMI DEVI PASHI | Contact No | 9804004597 |
| Address | SITAL SARKAR LANE | Age | 60 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||