Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05792 | Date 05/05/2022 |
| Token No | SM/22-23/2883 05/05/2022 | Serial | 022 |
| Patient Name | Mrs. NITU DEBI.. | Contact No | 9903605362 |
| Address | 12 INDIA JUTE MILL | Age | 20 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||