Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12942 | Date 30/04/2025 |
| Token No | SM/25-26/320 30/04/2025 | Serial | 013 |
| Patient Name | Mrs. USHA DEBI | Contact No | 8420383364 |
| Address | RAM SITA LANE | Age | 33 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||