Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 05988 | Date 31/05/2022 |
| Token No | SM/22-23/3194 31/05/2022 | Serial | 014 |
| Patient Name | Mrs. RINA DAS | Contact No | 9239041206 |
| Address | 14/B NEHERU NAGAR COLONY | Age | 56 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||