Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 11016 | Date 03/01/2024 |
| Token No | SM/22-23/14809 20/02/2024 | Serial | 018 |
| Patient Name | Mrs. SUJATA SAMANTA | Contact No | 9064036409 |
| Address | PANTAHARI, BALIPUR | Age | 46YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||