Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 10330 | Date 07/09/2023 |
| Token No | SM/22-23/12325 07/09/2023 | Serial | 018 |
| Patient Name | Mrs. RINKU SHAW | Contact No | 6204624210 |
| Address | NAYABAGAN RAM SITA LANE | Age | 26 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||