Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 04341 | Date 28/04/2021 |
| Token No | SM/21-22/184 28/04/2021 | Serial | 002 |
| Patient Name | Mrs. RENU PAL | Contact No | 8013325160 |
| Address | 96/A THAKUR BATI STREET | Age | 70 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||