Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05833 | Date 12/05/2022 |
| Token No | SM/22-23/2953 12/05/2022 | Serial | 010 |
| Patient Name | Mrs. KANIKA DEY | Contact No | 7003732267 |
| Address | 8D/3 DEY STREET | Age | 33 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||