Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 05089 | Date 24/11/2021 |
| Token No | SM/21-22/1471 24/11/2021 | Serial | 020 |
| Patient Name | Mrs. MALA DAS | Contact No | 9674192141 |
| Address | 24 AKHRABATI LANE | Age | 40 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||