Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03207 | Date 17/10/2019 |
| Token No | SM/22-23/15494 28/03/2024 | Serial | 029 |
| Patient Name | Mrs. SILA DEBI | Contact No | NOT GIVEN |
| Address | 6 DEY GHAT LANE | Age | 46 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||