Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08748 | Date 11/04/2023 |
| Token No | SM/22-23/8837 11/04/2023 | Serial | 003 |
| Patient Name | Mrs. BABY DEBI | Contact No | NOT GIVEN |
| Address | RAM SITA LANE | Age | 30 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||