Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 06443 | Date 22/07/2022 |
| Token No | SM/22-23/3977 22/07/2022 | Serial | 016 |
| Patient Name | Mrs. FULBANTI DEBI | Contact No | 9123636902 |
| Address | 6 NO RAM SITA LANE | Age | 30 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||