Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 08796 | Date 21/04/2023 |
| Token No | SM/22-23/9013 21/04/2023 | Serial | 033 |
| Patient Name | Mrs. PRITI DEBI | Contact No | NOT GIVEN |
| Address | 58 AKHRA BATI LANE | Age | 23 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||