Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 11187 | Date 21/02/2024 |
| Token No | SM/22-23/14876 21/02/2024 | Serial | 045 |
| Patient Name | Mrs. PIYALI BAIDYA | Contact No | 9330307940 |
| Address | 9 NO RAM SITA LANE | Age | 26 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||