Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04359 | Date 05/05/2021 |
| Token No | SM/21-22/217 05/05/2021 | Serial | 005 |
| Patient Name | Mrs. ARATI PODDAR | Contact No | 9836903085 |
| Address | 45 DEY STREET | Age | 42 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||