Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 07543 | Date 07/11/2022 |
| Token No | SM/22-23/13654 09/12/2023 | Serial | 014 |
| Patient Name | Mrs. CHANCHALA SHAW | Contact No | 9088153632 |
| Address | 45 PANCHU GOPAL BHADURI SARANI | Age | 51 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||