Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09116 | Date 19/05/2023 |
| Token No | SM/22-23/9695 19/05/2023 | Serial | 017 |
| Patient Name | Mrs. IZRA DEBI | Contact No | NOT GIVEN |
| Address | INDIA JUTE MILL | Age | 50 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||