Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 07202 | Date 11/10/2022 |
| Token No | SM/22-23/6733 30/11/2022 | Serial | 022 |
| Patient Name | Mrs. MANJU SHA | Contact No | NOT GIVEN |
| Address | 2 MAIDA PATTY LANE | Age | 46 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||