Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 13060 | Date 26/05/2025 |
| Token No | SM/25-26/992 26/06/2025 | Serial | 012 |
| Patient Name | Mrs. SUGANDHIT DEVI | Contact No | 8981681478 |
| Address | 6 RAM SITA LANE | Age | 23 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||