Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05842 | Date 17/05/2022 |
| Token No | SM/22-23/2975 17/05/2022 | Serial | 001 |
| Patient Name | Mrs. LABONI DAS | Contact No | 7586811285 |
| Address | 3 PITAMBAR DEY LANE | Age | 28 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||