Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04535 | Date 25/06/2021 |
| Token No | SM/21-22/499 25/06/2021 | Serial | 008 |
| Patient Name | Mrs. MANASI DAS | Contact No | 8478928013 |
| Address | 60 DEY STREET | Age | 35 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||