Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04789 | Date 24/08/2021 |
| Token No | SM/25-26/656 04/06/2025 | Serial | 021 |
| Patient Name | Mrs. JANKI DEBI | Contact No | 9330731134 |
| Address | 5 DOSTI LANE | Age | 50 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||