Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05631 | Date 01/04/2022 |
| Token No | SM/22-23/2587 01/04/2022 | Serial | 008 |
| Patient Name | Mrs. PAMPA KOLEY | Contact No | 9903422653 |
| Address | 23A/1 PANCHANAN TALA LANE | Age | 36 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||