Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 06923 | Date 06/09/2022 |
| Token No | SM/22-23/11639 16/08/2023 | Serial | 012 |
| Patient Name | Mrs. JULI DEBI | Contact No | 6290117929 |
| Address | 7 INDIA JUTE MILL | Age | 27 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||