Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05788 | Date 05/05/2022 |
| Token No | SM/22-23/2878 05/05/2022 | Serial | 017 |
| Patient Name | Mrs. SARITA DEBI.. | Contact No | 8910559779 |
| Address | 6 RAM SITA LANE | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||