Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10079 | Date 22/08/2023 |
| Token No | SM/24-25/17585 18/07/2024 | Serial | 027 |
| Patient Name | Mrs. LILAWATI DEBI | Contact No | 7044576243 |
| Address | 6/240 RAM SITA LANE | Age | 49 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||