Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04457 | Date 08/06/2021 |
| Token No | SM/21-22/381 08/06/2021 | Serial | 011 |
| Patient Name | Mrs. RUPA JAISOWARA | Contact No | 8777457668 |
| Address | 17/A/3 CHAUDHURI PARA LANE | Age | 28 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||