Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 09191 | Date 29/05/2023 |
| Token No | SM/22-23/9857 29/05/2023 | Serial | 004 |
| Patient Name | Miss SANJANA KUMARI DAS | Contact No | 9123000585 |
| Address | 104 R B SARANI | Age | 20 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||