Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 10121 | Date 24/08/2023 |
| Token No | SM/22-23/11943 24/08/2023 | Serial | 010 |
| Patient Name | Miss ISHIKA DAS | Contact No | 7890566992 |
| Address | 159 DEY BAGAN | Age | 20 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||