Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 11019 | Date 04/01/2024 |
| Token No | SM/22-23/14100 04/01/2024 | Serial | 002 |
| Patient Name | Mrs. SANGITA DEBI | Contact No | 9062710536 |
| Address | 14 DEY STREET | Age | 43 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||