Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 09109 | Date 18/05/2023 |
| Token No | SM/22-23/9665 18/05/2023 | Serial | 025 |
| Patient Name | Mrs. MRIDULA PANDIT | Contact No | NOT GIVEN |
| Address | MANNA PARA | Age | 72 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||