Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 05517 | Date 09/03/2022 |
| Token No | SM/21-22/2381 09/03/2022 | Serial | 009 |
| Patient Name | Mrs. TUMPA MANNA | Contact No | 6289570727 |
| Address | 43/A DHULIPARA LANE | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||