Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04305 | Date 20/04/2021 |
| Token No | SM/21-22/120 20/04/2021 | Serial | 014 |
| Patient Name | Mrs. SARDHA GIRI | Contact No | 8420335199 |
| Address | INDIA JUTE MILL | Age | 55 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||