Ticket for Outdoor Patient
| Ward No. 23 | U-PHC No. | Registration No. 05857 | Date 17/05/2022 |
| Token No | SM/22-23/2991 17/05/2022 | Serial | 017 |
| Patient Name | Miss PRATIMA KUMARI KAHAR | Contact No | 8303888855 |
| Address | 70/A/2/126 KHATIR BAZAR | Age | 25 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||