Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05666 | Date 05/04/2022 |
| Token No | SM/22-23/2644 05/04/2022 | Serial | 009 |
| Patient Name | Mrs. PURNIMA LAKHAN | Contact No | 9748932894 |
| Address | CHOTO BELU | Age | 40 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||