Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09255 | Date 05/06/2023 |
| Token No | SM/22-23/14664 08/02/2024 | Serial | 013 |
| Patient Name | Mrs. CHANDRANI SAMANTA | Contact No | 9100289010 |
| Address | CHHOTO BELU | Age | 44 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||