Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 06720 | Date 13/08/2022 |
| Token No | SM/22-23/4514 13/08/2022 | Serial | 003 |
| Patient Name | Mrs. GOURI BHAR | Contact No | 8478520152 |
| Address | 67/A BHAGIRATHI LANE | Age | 44 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||