Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 11363 | Date 03/04/2024 |
| Token No | SM/24-25/15591 03/04/2024 | Serial | 017 |
| Patient Name | Mrs. KALPANA DOLUI | Contact No | 9330982165 |
| Address | PAL BAGAN | Age | 51 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||