Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03051 | Date 16/09/2019 |
| Token No | SM/24-25/17967 07/08/2024 | Serial | 010 |
| Patient Name | Mrs. SANDHYARI DEBI | Contact No | NOT GIVEN |
| Address | RAM SITA LINE | Age | 41 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||