Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 06555 | Date 29/07/2022 |
| Token No | SM/22-23/4188 29/07/2022 | Serial | 017 |
| Patient Name | Mrs. SUJATA DAS | Contact No | 9830986589 |
| Address | 40 DOSTI LANE | Age | 44 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||