Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 10731 | Date 03/11/2023 |
| Token No | SM/22-23/13176 03/11/2023 | Serial | 001 |
| Patient Name | Miss DAMINI DOM | Contact No | 7044074422 |
| Address | 77 THAKURBATI STREET | Age | 21 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||