Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 11155 | Date 20/02/2024 |
| Token No | SM/22-23/14802 20/02/2024 | Serial | 011 |
| Patient Name | Mrs. SHITABI KOIRI | Contact No | |
| Address | 79 DEY STREET | Age | 59 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||