Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05579 | Date 23/03/2022 |
| Token No | SM/22-23/14807 20/02/2024 | Serial | 016 |
| Patient Name | Mrs. SRIPATI DEBI | Contact No | NOT GIVEN |
| Address | C/1 A B GARDEN LANE | Age | 61 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||