Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05370 | Date 31/01/2022 |
| Token No | SM/21-22/2049 31/01/2022 | Serial | 013 |
| Patient Name | Mrs. KIRAN DAS | Contact No | 9073731251 |
| Address | 78 DEY STREET | Age | 22 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||