Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 06787 | Date 22/08/2022 |
| Token No | SM/22-23/5722 21/10/2022 | Serial | 022 |
| Patient Name | Mrs. SEEMA KUMARI | Contact No | 8102127889 |
| Address | 12 NO. LINE, INDIA JUTE MILL | Age | 20 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||