Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10533 | Date 26/09/2023 |
| Token No | SM/22-23/12698 26/09/2023 | Serial | 014 |
| Patient Name | Mrs. JASHODA GUPTA | Contact No | 9163337490 |
| Address | 1ST K.M. BHATTACHARYA STREET | Age | Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||