Ticket for Outdoor Patient
| Ward No. 25 | U-PHC No. | Registration No. 04970 | Date 05/10/2021 |
| Token No | SM/21-22/1239 05/10/2021 | Serial | 005 |
| Patient Name | Mrs. KAJAL DAS | Contact No | 9748147330 |
| Address | 2/106 MAHESH COLONY | Age | 46 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||