Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 05749 | Date 22/04/2022 |
| Token No | SM/22-23/2795 22/04/2022 | Serial | 001 |
| Patient Name | Mrs. MRIDULA ADHIKARY | Contact No | NOT GIVEN |
| Address | 46 PATUA PARA | Age | 40 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||