Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04675 | Date 03/08/2021 |
| Token No | SM/21-22/752 03/08/2021 | Serial | 012 |
| Patient Name | Miss SANGITA BHOLO | Contact No | 9330783805 |
| Address | INDIA JUTE MILL | Age | 32 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||