Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05356 | Date 28/01/2022 |
| Token No | SM/24-25/16505 27/05/2024 | Serial | 011 |
| Patient Name | Mrs. TETARI DEBI | Contact No | 8100421248 |
| Address | 3 DEY GHAT LANE | Age | 51 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||