Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 06069 | Date 13/06/2022 |
| Token No | SM/22-23/3354 13/06/2022 | Serial | 005 |
| Patient Name | Miss RITA DAS | Contact No | 8902451474 |
| Address | 95/A THAKUR BATI STREET | Age | 30 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||