Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 05615 | Date 31/03/2022 |
| Token No | SM/21-22/2564 31/03/2022 | Serial | 019 |
| Patient Name | Mrs. SUJAN DAS | Contact No | 6200466471 |
| Address | 100 R B SARANI | Age | 27 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||