Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 11212 | Date 29/02/2024 |
| Token No | SM/22-23/15007 29/02/2024 | Serial | 004 |
| Patient Name | Mrs. BAISAKHI DAS | Contact No | NOT GIVEN |
| Address | 38 AKHRABATI LANE | Age | 23 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||