Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 06860 | Date 01/09/2022 |
| Token No | SM/22-23/4793 01/09/2022 | Serial | 013 |
| Patient Name | Mrs. KIRAN ROY | Contact No | 8617240397 |
| Address | 43 BHAGIRATHI LANE | Age | 27 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||