Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05632 | Date 04/04/2022 |
| Token No | SM/22-23/2596 04/04/2022 | Serial | 002 |
| Patient Name | Mrs. RANI PATRA | Contact No | NOT GIVEN |
| Address | 6/A BANERJEE PARA | Age | 40 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||