Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 08680 | Date 31/03/2023 |
| Token No | SM/25-26/631 03/06/2025 | Serial | 002 |
| Patient Name | Mrs. SAROJ DEBI | Contact No | 9088586388 |
| Address | 43 BHAGIRATHI LANE | Age | 27 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||