Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 07211 | Date 12/10/2022 |
| Token No | SM/22-23/5441 12/10/2022 | Serial | 010 |
| Patient Name | Mrs. CHAMPA DEBI | Contact No | 8420593743 |
| Address | 14 AKHRABATI LANE | Age | 65 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||