Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 07697 | Date 16/11/2022 |
| Token No | SM/22-23/6596 24/11/2022 | Serial | 010 |
| Patient Name | Mrs. PUJA DEBI. | Contact No | 9163196508 |
| Address | 11/303 RAM SITA LANE | Age | 20 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||