Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10261 | Date 01/09/2023 |
| Token No | SM/22-23/12185 01/09/2023 | Serial | 021 |
| Patient Name | Mrs. KALPANA CHAUHAN | Contact No | 9088675003 |
| Address | BANERJEE PARA | Age | 30 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||