Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 06625 | Date 04/08/2022 |
| Token No | SM/22-23/4311 04/08/2022 | Serial | 025 |
| Patient Name | Mrs. JHARNA DAS | Contact No | |
| Address | 104 N.N. COLONY | Age | 62 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||