Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 09564 | Date 06/07/2023 |
| Token No | SM/24-25/16691 05/06/2024 | Serial | 029 |
| Patient Name | Mrs. NILAM DEVI | Contact No | NOT GIVEN |
| Address | DEY GHAT LANE | Age | 23 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||