Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 05423 | Date 14/02/2022 |
| Token No | SM/21-22/2147 14/02/2022 | Serial | 005 |
| Patient Name | Mrs. MINU SHIL | Contact No | NOT GIVEN |
| Address | 121/A N N COLONY | Age | 60 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||