Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 06003 | Date 07/06/2022 |
| Token No | SM/22-23/3235 07/06/2022 | Serial | 001 |
| Patient Name | Miss JYOTI GUCHHAYIT | Contact No | 9123807673 |
| Address | J.N LAHIRI ROAD | Age | 20 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||