Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01793 | Date 13/03/2019 |
| Token No | SM/24-25/20112 09/12/2024 | Serial | 031 |
| Patient Name | Mrs. GIRIJA DEBI | Contact No | NOT GIVEN |
| Address | 6 NO RAM SITA LANE | Age | 61 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||