Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05950 | Date 26/05/2022 |
| Token No | SM/22-23/3131 26/05/2022 | Serial | 017 |
| Patient Name | Mrs. PUJA DAS | Contact No | NOT GIVEN |
| Address | MANIKTALA, 573 G.T ROAD | Age | 40 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||