Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 03987 | Date 14/07/2020 |
| Token No | SM/22-23/13839 16/12/2023 | Serial | 019 |
| Patient Name | Mrs. CHANDANA DAS | Contact No | 9330115652 |
| Address | 501 G T ROAD MAHESH SODEGOPE PARA | Age | 37 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||