Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 11265 | Date 11/03/2024 |
| Token No | SM/22-23/15181 11/03/2024 | Serial | 032 |
| Patient Name | Mrs. ANIMA SAMANTA | Contact No | 9143289010 |
| Address | CHOTOBELU | Age | 62 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||