Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 09883 | Date 04/08/2023 |
| Token No | SM/22-23/11406 04/08/2023 | Serial | 034 |
| Patient Name | Mrs. SIULI DAS | Contact No | 9163462143 |
| Address | 41/C KHASH BAGAN LANE | Age | 34 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||