Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05207 | Date 04/01/2022 |
| Token No | SM/21-22/1766 04/01/2022 | Serial | 003 |
| Patient Name | Mrs. PARUL DAS.. | Contact No | NOT GIVEN |
| Address | 36 DOSTI LANE | Age | 55 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||