Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 12198 | Date 04/10/2024 |
| Token No | SM/24-25/19177 04/10/2024 | Serial | 012 |
| Patient Name | Mrs. NITU SHA | Contact No | 7305064156 |
| Address | 43 BHAGIRATHI LANE | Age | 31 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||