Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 12291 | Date 31/10/2024 |
| Token No | SM/24-25/19546 31/10/2024 | Serial | 006 |
| Patient Name | Mrs. RENUKA DAS. | Contact No | 7003410770 |
| Address | 3A B.P. 2ND LANE | Age | 93 yrs Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||