Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 11397 | Date 12/04/2024 |
| Token No | SM/24-25/15706 12/04/2024 | Serial | 003 |
| Patient Name | Mrs. DOLA DAS | Contact No | 7980829875 |
| Address | 628/1 G T ROAD KALITALA | Age | 54 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||