Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 06916 | Date 05/09/2022 |
| Token No | SM/22-23/4874 05/09/2022 | Serial | 027 |
| Patient Name | Mrs. CHAMPA DAS. | Contact No | 8013156326 |
| Address | 80 R B SARANI | Age | 58 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||