Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 08062 | Date 29/12/2022 |
| Token No | SM/22-23/7252 29/12/2022 | Serial | 013 |
| Patient Name | Miss KIRAN DAS | Contact No | NOT GIVEN |
| Address | 96 R B SARANI | Age | 21 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||