Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 05074 | Date 24/11/2021 |
| Token No | SM/21-22/1452 24/11/2021 | Serial | 001 |
| Patient Name | Mrs. JANKI DEBI.. | Contact No | 8777511709 |
| Address | 126 R B SARANI | Age | 45 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||