Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 11174 | Date 21/02/2024 |
| Token No | SM/22-23/14839 21/02/2024 | Serial | 008 |
| Patient Name | Mrs. SARITA DEBI | Contact No | 6200397019 |
| Address | RAM SITA LANE | Age | 30 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||