Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04725 | Date 16/08/2021 |
| Token No | SM/21-22/838 16/08/2021 | Serial | 002 |
| Patient Name | Mrs. PRIYATUNG DEY | Contact No | 7074949373 |
| Address | 12A KASHI DR. LANE | Age | 20 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||