Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 11280 | Date 14/03/2024 |
| Token No | SM/25-26/957 25/06/2025 | Serial | 011 |
| Patient Name | Mrs. UMRABATI DEBI | Contact No | 8099105858 |
| Address | NAYA BAGAN, RAM SITA LANE | Age | 56 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||