Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 06237 | Date 28/06/2022 |
| Token No | SM/22-23/3642 28/06/2022 | Serial | 019 |
| Patient Name | Mrs. KAKALI ADAK | Contact No | 7596925043 |
| Address | 18 AKHRA BATI LANE | Age | 22 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||