Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 12895 | Date 21/04/2025 |
| Token No | SM/25-26/1091 04/07/2025 | Serial | 002 |
| Patient Name | Mrs. MITNI RAJBHAR | Contact No | 9123750538 |
| Address | DEY STREET | Age | 60 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||