Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 14812 | Date 27/08/2026 |
| Token No | SM/25-26/5608 27/08/2026 | Serial | 014 |
| Patient Name | Mrs. KM JYOTI | Contact No | 6290267702 |
| Address | 31/B DR NLB STREET | Age | 26 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||