Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 06830 | Date 29/08/2022 |
| Token No | SM/22-23/4735 29/08/2022 | Serial | 006 |
| Patient Name | Mrs. RINA DEVI | Contact No | 6204544660 |
| Address | 4 SITAL SARKAR LANE | Age | 35 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||