Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 05368 | Date 31/01/2022 |
| Token No | SM/21-22/2293 28/02/2022 | Serial | 018 |
| Patient Name | Miss SIMRAN DAS | Contact No | 9830706830 |
| Address | 120 PATUA PARA LANE | Age | 18 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||