Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09104 | Date 18/05/2023 |
| Token No | SM/22-23/9658 18/05/2023 | Serial | 018 |
| Patient Name | Mrs. NIRMALA DEBI | Contact No | 9155967546 |
| Address | 6 NO RAM SITA LANE | Age | 35 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||