Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04004 | Date 14/08/2020 |
| Token No | SM/22-23/2714 19/04/2022 | Serial | 005 |
| Patient Name | Mrs. SOMA DAS | Contact No | 8981218370 |
| Address | 573 MANIKTALA | Age | 41 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||