Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04531 | Date 24/06/2021 |
| Token No | SM/21-22/1454 24/11/2021 | Serial | 003 |
| Patient Name | Mrs. ARTI DAS | Contact No | 7439845158 |
| Address | MANIKTALA | Age | 19 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||