Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 06591 | Date 03/08/2022 |
| Token No | SM/22-23/4260 03/08/2022 | Serial | 006 |
| Patient Name | Mrs. TAPU BANIK | Contact No | 9883520025 |
| Address | 28 AKHRA BATI LANE | Age | 46 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||