Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 07636 | Date 14/11/2022 |
| Token No | SM/22-23/6264 14/11/2022 | Serial | 017 |
| Patient Name | Mrs. SUDAMA DEBI | Contact No | NOT GIVEN |
| Address | 62 RAILAND ROAD | Age | 61 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||