Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 05021 | Date 29/10/2021 |
| Token No | SM/21-22/1346 29/10/2021 | Serial | 005 |
| Patient Name | Mrs. RATNA BHADRA DEY | Contact No | 8902004465 |
| Address | 42 DHULIPARA | Age | 50 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||