Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05964 | Date 27/05/2022 |
| Token No | SM/22-23/3160 27/05/2022 | Serial | 024 |
| Patient Name | Mrs. SABITA DUTTA | Contact No | NOT GIVEN |
| Address | 646 G T ROAD | Age | 31 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||