Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 05799 | Date 06/05/2022 |
| Token No | SM/22-23/2894 06/05/2022 | Serial | 003 |
| Patient Name | Mrs. KABITA SASMAL.. | Contact No | NOT GIVEN |
| Address | BHAGIRATHI LANE | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||