Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03562 | Date 06/12/2019 |
| Token No | SM/21-22/1673 20/12/2021 | Serial | 007 |
| Patient Name | Mrs. SHANTI BISWAL | Contact No | 8100218312 |
| Address | N L BHATTACHARYA STREET | Age | 47 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||