Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08996 | Date 10/05/2023 |
| Token No | SM/22-23/9470 10/05/2023 | Serial | 030 |
| Patient Name | Mrs. MAMATA GOMESH | Contact No | 8777410494 |
| Address | 81 DTR | Age | 29 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||