Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 04411 | Date 24/05/2021 |
| Token No | SM/21-22/304 24/05/2021 | Serial | 002 |
| Patient Name | Miss SOUMI DEY | Contact No | 8697275302 |
| Address | 22 THAKUR BATI STREET | Age | 23 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||