Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 09511 | Date 30/06/2023 |
| Token No | SM/22-23/10522 30/06/2023 | Serial | 025 |
| Patient Name | Mrs. RIMPA KHAN SAHA | Contact No | 9836438667 |
| Address | 49 DEY STREET, BOTTALA | Age | 31 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||