Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 07212 | Date 12/10/2022 |
| Token No | SM/22-23/13835 16/12/2023 | Serial | 015 |
| Patient Name | Mrs. PREMSILA ROY | Contact No | 9007754737 |
| Address | 56 AKHRA BATI LANE | Age | 37 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||