Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 04378 | Date 12/05/2021 |
| Token No | SM/24-25/20564 17/01/2025 | Serial | 014 |
| Patient Name | Mrs. ADURI DAS | Contact No | NOT GIVEN |
| Address | 17 K M SHA STREET | Age | 57 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||