Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 05215 | Date 04/01/2022 |
| Token No | SM/22-23/3142 27/05/2022 | Serial | 006 |
| Patient Name | Mrs. PUNAM DEBI.. | Contact No | 7890953563 |
| Address | 126 R B SARANI | Age | 27 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||