Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 11483 | Date 06/05/2024 |
| Token No | SM/25-26/6098 28/10/2026 | Serial | 018 |
| Patient Name | Mrs. BHARATI NATH | Contact No | 9836388042 |
| Address | PAL BAGAN | Age | 73 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||