Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04734 | Date 16/08/2021 |
| Token No | SM/22-23/8498 23/03/2023 | Serial | 009 |
| Patient Name | Mrs. NILAM DEVI | Contact No | 9062942996 |
| Address | 10 DEY STREET | Age | 22 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||