Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 05470 | Date 24/02/2022 |
| Token No | SM/21-22/2253 24/02/2022 | Serial | 001 |
| Patient Name | Mrs. KANCHAN KAR | Contact No | 8017148062 |
| Address | 118 G T ROAD | Age | 60 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||