Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 12869 | Date 07/04/2025 |
| Token No | SM/25-26/439 13/05/2025 | Serial | 004 |
| Patient Name | Mrs. SUMAN SHAW | Contact No | 9051283389 |
| Address | PACHU BAZAR | Age | 30 Y Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||