Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 06358 | Date 16/07/2022 |
| Token No | SM/22-23/3862 16/07/2022 | Serial | 003 |
| Patient Name | Mrs. PIYA DAS | Contact No | 6289738714 |
| Address | 453/A G.T.ROAD | Age | 26 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||