Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 06355 | Date 14/07/2022 |
| Token No | SM/24-25/16341 17/05/2024 | Serial | 011 |
| Patient Name | Mrs. MAMPI KOLEY | Contact No | NOT GIVEN |
| Address | 129 AKHRABATI LANE | Age | 31 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||