Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 08071 | Date 30/12/2022 |
| Token No | SM/22-23/7277 30/12/2022 | Serial | 007 |
| Patient Name | Mrs. SUNITA DEBI TANTI | Contact No | 7890671406 |
| Address | 104 R B SARANI | Age | 34 Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||