Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13148 | Date 24/06/2025 |
| Token No | SM/25-26/944 24/06/2025 | Serial | 001 |
| Patient Name | Mrs. DAYABATI DEBI | Contact No | 6290913860 |
| Address | DEY STREET, SINGHA GOLI | Age | 74 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||