Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 06128 | Date 17/06/2022 |
| Token No | SM/22-23/3462 17/06/2022 | Serial | 010 |
| Patient Name | Mrs. ARUNIMA KOLEY | Contact No | 7278948418 |
| Address | 23A/1 PANCHANAN TALA LANE | Age | 45 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||