Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 06763 | Date 17/08/2022 |
| Token No | SM/22-23/4582 17/08/2022 | Serial | 014 |
| Patient Name | Mrs. SHANKARI DAS.. | Contact No | 9062376072 |
| Address | 35 PANCHANAN TALA LANE | Age | 31 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||