Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12675 | Date 17/02/2025 |
| Token No | SM/24-25/20991 17/02/2025 | Serial | 011 |
| Patient Name | Mrs. SHARMILA DEBI | Contact No | 7061201072 |
| Address | RAM SITA LANE | Age | 26 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||