Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04957 | Date 30/09/2021 |
| Token No | SM/21-22/1218 30/09/2021 | Serial | 004 |
| Patient Name | Mrs. SIKHA MITRA | Contact No | 9163101934 |
| Address | 14 PANCHANAN TALA LANE | Age | 35 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||