Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 05702 | Date 19/04/2022 |
| Token No | SM/22-23/2719 19/04/2022 | Serial | 010 |
| Patient Name | Mrs. SHAMPA DIG | Contact No | 9163216795 |
| Address | 42 BHAGIRATHI LANE | Age | 46 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||