Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05696 | Date 18/04/2022 |
| Token No | SM/22-23/9320 02/05/2023 | Serial | 032 |
| Patient Name | Mrs. DHURPATI DEBI | Contact No | NOT GIVEN |
| Address | A B GARDEN LANE | Age | 21 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||