Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 05165 | Date 17/12/2021 |
| Token No | SM/21-22/1660 17/12/2021 | Serial | 005 |
| Patient Name | Mrs. BHARATI DEY. | Contact No | 7685886431 |
| Address | KHAS BAGAN LANE | Age | 49 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||