Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05261 | Date 10/01/2022 |
| Token No | SM/21-22/1840 10/01/2022 | Serial | 004 |
| Patient Name | Mrs. MAMONI BAIRAGI | Contact No | 7980551246 |
| Address | 28B PANCHANAN TALA LANE | Age | 24 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||