Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 11638 | Date 11/06/2024 |
| Token No | SM/24-25/16804 11/06/2024 | Serial | 012 |
| Patient Name | Mrs. JYOTI SHAW | Contact No | 8335985206 |
| Address | 82 DEY STREET | Age | 12 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||