Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 12984 | Date 14/05/2025 |
| Token No | SM/25-26/443 14/05/2025 | Serial | 004 |
| Patient Name | Miss NILU KUMARI | Contact No | 7549814490 |
| Address | 79 DEY STREET | Age | 23 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||