Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08390 | Date 20/02/2023 |
| Token No | SM/24-25/16683 05/06/2024 | Serial | 021 |
| Patient Name | Mrs. DIPALI RAJBHAR | Contact No | 8777521443 |
| Address | 10 DEY SREET | Age | 27 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||