Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 11946 | Date 12/08/2024 |
| Token No | SM/24-25/18122 12/08/2024 | Serial | 011 |
| Patient Name | Mrs. PURNIMA DEBI DAS | Contact No | |
| Address | 55 RAYLAND ROAD | Age | 60 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||