Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 06112 | Date 16/06/2022 |
| Token No | SM/24-25/18267 20/08/2024 | Serial | 010 |
| Patient Name | Mrs. SULEKHA SHAW | Contact No | 8820658675 |
| Address | 6 KAMAR PATTY | Age | 26 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||