Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01266 | Date 01/11/2018 |
| Token No | SM/21-22/273 18/05/2021 | Serial | 004 |
| Patient Name | Mrs. RUBY DEBI | Contact No | 8335862752 |
| Address | 3 DEY GHAT LANE | Age | 36 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||