Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 04984 | Date 25/10/2021 |
| Token No | SM/21-22/1269 25/10/2021 | Serial | 007 |
| Patient Name | Mrs. MONI ROY | Contact No | NOT GIVEN |
| Address | 23/B THAKUR BATI | Age | 60 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||