Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 13169 | Date 26/06/2025 |
| Token No | SM/25-26/985 26/06/2025 | Serial | 005 |
| Patient Name | Mrs. ANIMA SHAW. | Contact No | 9163899748 |
| Address | 83 DEY STREET | Age | 35 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||