Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 07733 | Date 21/11/2022 |
| Token No | SM/22-23/6678 28/11/2022 | Serial | 027 |
| Patient Name | Mrs. CHANDRAWATI DEBI | Contact No | 7781836518 |
| Address | 8 NO LINE | Age | 45 Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||