Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 10105 | Date 23/08/2023 |
| Token No | SM/22-23/11893 23/08/2023 | Serial | 015 |
| Patient Name | Mrs. SUSHAMA DAS | Contact No | 9863035703 |
| Address | 31 AKHRABATI LANE | Age | 65 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||