Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09996 | Date 16/08/2023 |
| Token No | SM/25-26/762 11/06/2025 | Serial | 025 |
| Patient Name | Mrs. RANI DAS | Contact No | |
| Address | 14/c dey street | Age | 45 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||