Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05092 | Date 24/11/2021 |
| Token No | SM/21-22/1476 24/11/2021 | Serial | 025 |
| Patient Name | Mrs. MAMTA SINGH | Contact No | 9875409581 |
| Address | 23 N L BHATTACHARJEE STREET | Age | 46 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||