Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05339 | Date 24/01/2022 |
| Token No | SM/22-23/3951 21/07/2022 | Serial | 006 |
| Patient Name | Mrs. NIBHA DEBI | Contact No | NOT GIVEN |
| Address | 90/C DEY STREET | Age | 45 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||