Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 04358 | Date 05/05/2021 |
| Token No | SM/21-22/216 05/05/2021 | Serial | 004 |
| Patient Name | Mrs. NIBEDITA BHAR | Contact No | 9051933412 |
| Address | 115 G.T.ROAD, MANIKTALA | Age | 23 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||