Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 09815 | Date 01/08/2023 |
| Token No | SM/22-23/11274 01/08/2023 | Serial | 001 |
| Patient Name | Mrs. KAMLI DEBI | Contact No | 8100064003 |
| Address | 16/T SITAL SARKAR LANE | Age | 45 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||