Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 06177 | Date 21/06/2022 |
| Token No | SM/22-23/3524 21/06/2022 | Serial | 017 |
| Patient Name | Miss RANITA DAS | Contact No | NOT GIVEN |
| Address | 112 THAKUR BATI ST. | Age | 29 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||