Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 05875 | Date 19/05/2022 |
| Token No | SM/22-23/3018 19/05/2022 | Serial | 001 |
| Patient Name | Mrs. JHUMA BAG | Contact No | 7439786508 |
| Address | 11 JANNAGAR ROAD | Age | 28 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||