Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 08107 | Date 04/01/2023 |
| Token No | SM/22-23/11013 19/07/2023 | Serial | 004 |
| Patient Name | Mrs. LALITA DEBI | Contact No | 7686909579 |
| Address | 3 DOSTI LANE | Age | 33 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||