Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 05800 | Date 06/05/2022 |
| Token No | SM/22-23/2895 06/05/2022 | Serial | 004 |
| Patient Name | Mrs. NAMITAPATRA | Contact No | 6289570727 |
| Address | 43/A DHULIPARA LANE | Age | 50 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||