Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09635 | Date 17/07/2023 |
| Token No | SM/22-23/10924 17/07/2023 | Serial | 007 |
| Patient Name | Mrs. CHHABI DAS | Contact No | 9163101741 |
| Address | 27 DEY STREET | Age | 78 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||