Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05191 | Date 23/12/2021 |
| Token No | SM/21-22/1724 23/12/2021 | Serial | 003 |
| Patient Name | Mrs. KABITA DAS | Contact No | 7439845158 |
| Address | MANKTALA | Age | 35 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||