Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 13082 | Date 09/06/2025 |
| Token No | SM/25-26/699 09/06/2025 | Serial | 015 |
| Patient Name | Mrs. GITA DEVI | Contact No | 9163899748 |
| Address | 10 DEY STREET | Age | 80 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||