Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09435 | Date 21/06/2023 |
| Token No | SM/22-23/10373 21/06/2023 | Serial | 019 |
| Patient Name | Mrs. ROMILA DEVI | Contact No | NOT GIVEN |
| Address | 9 INDIA JUTE MILL | Age | 55 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||