Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04442 | Date 03/06/2021 |
| Token No | SM/22-23/11383 04/08/2023 | Serial | 011 |
| Patient Name | Mrs. KEKA MANNA | Contact No | 9433110552 |
| Address | 29 CHOWDHURY PARA | Age | 71 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||