Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 08717 | Date 06/04/2023 |
| Token No | SM/22-23/8752 06/04/2023 | Serial | 005 |
| Patient Name | Mrs. MINA DAS | Contact No | 9163023165 |
| Address | 104 R B SARANI | Age | 57 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||