Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04349 | Date 29/04/2021 |
| Token No | SM/24-25/16587 30/05/2024 | Serial | 008 |
| Patient Name | Mrs. BABY ROY | Contact No | 8521054484 |
| Address | RAM SITA LINE | Age | 23 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||