Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 07226 | Date 13/10/2022 |
| Token No | SM/22-23/5468 13/10/2022 | Serial | 012 |
| Patient Name | Mrs. SUNITA DEVI | Contact No | NOT GIVEN |
| Address | INDIA JUTE MILL | Age | 40 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||