Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 03575 | Date 09/12/2019 |
| Token No | SM/22-23/14277 16/01/2024 | Serial | 006 |
| Patient Name | Mrs. SANGITA BHAR | Contact No | 9339120084 |
| Address | 47K/3 KUMIR JALA ROAD | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||