Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 06939 | Date 06/09/2022 |
| Token No | SM/22-23/7583 31/01/2023 | Serial | 030 |
| Patient Name | Mrs. LAKKHI SHAW | Contact No | NOT GIVEN |
| Address | 49/A RISHI BANKIM SARANI | Age | 50 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||