Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03659 | Date 03/01/2020 |
| Token No | SM/22-23/4164 28/07/2022 | Serial | 026 |
| Patient Name | Mrs. MANJU DAS | Contact No | |
| Address | JOLKOL WORKER | Age | 37 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||