Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 06106 | Date 15/06/2022 |
| Token No | SM/22-23/3422 15/06/2022 | Serial | 016 |
| Patient Name | Mrs. SANDHYA KUMARI DAS | Contact No | NOT GIVEN |
| Address | BAISHNAB PARA 1ST LANE | Age | 68 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||