Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01044 | Date 04/10/2018 |
| Token No | SM/21-22/23 05/04/2021 | Serial | 012 |
| Patient Name | Mrs. BABY ROY | Contact No | 9830644834 |
| Address | 18 PANCHANAN TALA LANE | Age | 52 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||