Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04714 | Date 12/08/2021 |
| Token No | SM/21-22/821 12/08/2021 | Serial | 006 |
| Patient Name | Mrs. BABLI DEBI | Contact No | 8274906010 |
| Address | PITAMBAR DEY LANE | Age | 22 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||