Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04523 | Date 23/06/2021 |
| Token No | SM/21-22/1135 16/09/2021 | Serial | 005 |
| Patient Name | Mrs. ARATI PANDIT | Contact No | NOT GIVEN |
| Address | CHOWDHURY PARA | Age | 70 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||