Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 13092 | Date 11/06/2025 |
| Token No | SM/25-26/740 11/06/2025 | Serial | 003 |
| Patient Name | Mrs. MAMPI PARUI | Contact No | 9051483023 |
| Address | 18 KHAS BAGAN LANE | Age | 37 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||