Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 06903 | Date 05/09/2022 |
| Token No | SM/22-23/4853 05/09/2022 | Serial | 006 |
| Patient Name | Mrs. BRINDABATI BISHAL | Contact No | NOT GIVEN |
| Address | 6 PAL BAGAN | Age | 56 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||