Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 01005 | Date 27/09/2018 |
| Token No | SM/22-23/4553 16/08/2022 | Serial | 028 |
| Patient Name | Mrs. KRITIKA DEY | Contact No | |
| Address | DEY STREET | Age | 25 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||