Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 04192 | Date 24/03/2021 |
| Token No | SM/22-23/2810 25/04/2022 | Serial | 008 |
| Patient Name | Mrs. MINA MAITY | Contact No | NOT GIVEN |
| Address | KHASBAGAN | Age | 46 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||