Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 12273 | Date 28/10/2024 |
| Token No | SM/25-26/2953 11/12/2025 | Serial | 001 |
| Patient Name | Mrs. LAKKHI RANI SHAW | Contact No | 8585040217 |
| Address | 10 RAIL QUATER | Age | 52 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||