Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 04090 | Date 10/11/2020 |
| Token No | SM/21-22/224 06/05/2021 | Serial | 002 |
| Patient Name | Mrs. BANDANA DAS | Contact No | 9230124014 |
| Address | 26 DHULI PARA LANE | Age | 68 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||