Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00272 | Date 11/08/2018 |
| Token No | SM/21-22/90 19/04/2021 | Serial | 003 |
| Patient Name | Mrs. KRISHNA DEY | Contact No | |
| Address | Age | 34 Female | |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||