Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01278 | Date 02/11/2018 |
| Token No | SM/22-23/14604 05/02/2024 | Serial | 033 |
| Patient Name | Miss SAMPA RAJBHAR | Contact No | 7278280240 |
| Address | 10 DEY STREET | Age | 23 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||