Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 06797 | Date 22/08/2022 |
| Token No | SM/22-23/4641 22/08/2022 | Serial | 029 |
| Patient Name | Mrs. SUPARNA DAS | Contact No | 9836273205 |
| Address | 22 POTUA PARA LANE | Age | 23 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||