Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00674 | Date 11/09/2018 |
| Token No | SM/22-23/5904 31/10/2022 | Serial | 016 |
| Patient Name | Mrs. MOUBANI SIMLAI | Contact No | 9674323488 |
| Address | 166/A/1 THAKUR BATI STREET | Age | 32 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||