Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04659 | Date 26/07/2021 |
| Token No | SM/22-23/13487 01/12/2023 | Serial | 002 |
| Patient Name | Mrs. MINU SEN | Contact No | 6289943051 |
| Address | 10 RUDRARAM PANDIT LANE | Age | 49 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||