Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 11478 | Date 06/05/2024 |
| Token No | SM/24-25/16070 06/05/2024 | Serial | 011 |
| Patient Name | Mrs. SAROJINI BISWAL | Contact No | 9062569009 |
| Address | 45 DR. N.L. BHATTACHARYA STREET | Age | 40 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||