Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 06853 | Date 31/08/2022 |
| Token No | SM/22-23/5103 14/09/2022 | Serial | 002 |
| Patient Name | Mrs. MADHURI SHA | Contact No | NOT GIVEN |
| Address | 2 MAIDA PATTY LANE | Age | 81 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||