Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05823 | Date 11/05/2022 |
| Token No | SM/22-23/2943 11/05/2022 | Serial | 018 |
| Patient Name | Mrs. POOJA DEVI ROY.. | Contact No | 8697612683 |
| Address | 9 RAM SITA LANE | Age | 25 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||