Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 05081 | Date 24/11/2021 |
| Token No | SM/21-22/1461 24/11/2021 | Serial | 010 |
| Patient Name | Mrs. KRISHNA DAS | Contact No | 9903144578 |
| Address | 155 N N COLONY | Age | 28 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||