Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 05043 | Date 12/11/2021 |
| Token No | SM/21-22/1383 12/11/2021 | Serial | 008 |
| Patient Name | Miss SROTOSWINI DUTTA | Contact No | 9007685908 |
| Address | 54A BARUIPARA LANE, CHATRA | Age | 21 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||