Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 07866 | Date 01/12/2022 |
| Token No | SM/22-23/6765 01/12/2022 | Serial | 019 |
| Patient Name | Mrs. PUJA DEBI | Contact No | 9163196508 |
| Address | 11 RAMSITA LANE | Age | 20 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||