Ticket for Outdoor Patient
| Ward No. 20 | U-PHC No. | Registration No. 09070 | Date 16/05/2023 |
| Token No | SM/22-23/14329 18/01/2024 | Serial | 001 |
| Patient Name | Mrs. DIPALI JANA | Contact No | 9674783522 |
| Address | 31I SHIBTALA LANE | Age | 44 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||