Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 04596 | Date 13/07/2021 |
| Token No | SM/21-22/603 13/07/2021 | Serial | 018 |
| Patient Name | Miss RAKHI BISWAS | Contact No | 9051164054 |
| Address | 109 R B SARANI | Age | 22 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||