Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 13901 | Date 29/12/2025 |
| Token No | SM/25-26/3113 29/12/2025 | Serial | 019 |
| Patient Name | Mrs. RUPA VERMA | Contact No | 8981596634 |
| Address | 6 NOTUN BAGAN | Age | 34 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||