Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 11111 | Date 08/02/2024 |
| Token No | SM/24-25/18805 17/09/2024 | Serial | 011 |
| Patient Name | Mrs. DAYABATI DEBI | Contact No | 8013218958 |
| Address | 17 DASTI LANE | Age | 75 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||