Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 06748 | Date 16/08/2022 |
| Token No | SM/22-23/4558 16/08/2022 | Serial | 033 |
| Patient Name | Mrs. JAYA DAS | Contact No | 8336852935 |
| Address | GHOSH PARA 1 ST LANE | Age | 59 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||