Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 05122 | Date 29/11/2021 |
| Token No | SM/25-26/3082 22/12/2025 | Serial | 020 |
| Patient Name | Mrs. KABITA SINGHA | Contact No | 9874392876 |
| Address | 105 R B SARANI | Age | 74 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||