Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 04382 | Date 13/05/2021 |
| Token No | SM/21-22/258 13/05/2021 | Serial | 004 |
| Patient Name | Mrs. JHUMA SAHA | Contact No | 8100504997 |
| Address | 68 NEHERU NAGAR COLONY | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||