Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09335 | Date 14/06/2023 |
| Token No | SM/22-23/10179 14/06/2023 | Serial | 001 |
| Patient Name | Mrs. ANITA DEBI | Contact No | 7439161552 |
| Address | RAM SITA LANE | Age | 35 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||