Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05986 | Date 31/05/2022 |
| Token No | SM/24-25/16373 21/05/2024 | Serial | 012 |
| Patient Name | Mrs. SHAKUNTALA DEVI | Contact No | NOT GIVEN |
| Address | 1 DEY GHAT LANE | Age | 56 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||