Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05072 | Date 23/11/2021 |
| Token No | SM/21-22/1439 23/11/2021 | Serial | 011 |
| Patient Name | Mrs. PUJA DAS | Contact No | 8420308867 |
| Address | 573 G.T.ROAD, MANIKTALA | Age | 40 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||