Ticket for Outdoor Patient
| Ward No. 10 | U-PHC No. | Registration No. 09064 | Date 15/05/2023 |
| Token No | SM/25-26/1170 11/07/2025 | Serial | 003 |
| Patient Name | Mrs. PARBATI DEBI | Contact No | NOT GIVEN |
| Address | BOTTALA | Age | 71 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||