Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 05943 | Date 27/12/2023 |
| Token No | SM/25-26/11109 27/11/2025 | Serial | 062 |
| Patient Name | Mrs. REHANA BEGAM | Contact No | 8274892363 |
| Address | 88/D MIYAJAN DARJI LANE 712203 | Age | 30 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||