Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02406 | Date 02/07/2019 |
| Token No | SM/21-22/2481 22/03/2022 | Serial | 002 |
| Patient Name | Mrs. DURGAWATI PATWA | Contact No | 7278979878 |
| Address | 79/A DEY STREET | Age | 38 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||