Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05040 | Date 12/11/2021 |
| Token No | SM/21-22/1377 12/11/2021 | Serial | 002 |
| Patient Name | Mrs. PURNIMA BAG | Contact No | 9073333859 |
| Address | 3 A B GARDEN LANE | Age | 29 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||