Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 05024 | Date 03/11/2021 |
| Token No | SM/24-25/17191 27/06/2024 | Serial | 022 |
| Patient Name | Mrs. MITHU SASHMAL | Contact No | NOT GIVEN |
| Address | BHAGIRATHI LANE | Age | 40 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||