Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03101 | Date 23/09/2019 |
| Token No | SM/22-23/13955 20/12/2023 | Serial | 032 |
| Patient Name | Mrs. JANKI DEBI | Contact No | NOT GIVEN |
| Address | 19 DOSTI LANE | Age | 45 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||