Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08667 | Date 28/03/2023 |
| Token No | SM/24-25/15876 22/04/2024 | Serial | 017 |
| Patient Name | Miss SONIA KUMARI | Contact No | 9123903953 |
| Address | 10 DEY STREET | Age | 15 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||