Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 07034 | Date 14/09/2022 |
| Token No | SM/22-23/5113 14/09/2022 | Serial | 012 |
| Patient Name | Mrs. LAXMI DAS | Contact No | 8961820942 |
| Address | 34 BARAL BAGAN | Age | 32 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||