Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 07043 | Date 15/09/2022 |
| Token No | SM/22-23/5130 15/09/2022 | Serial | 011 |
| Patient Name | Mrs. POOJA KUMARI ROY | Contact No | 9874831275 |
| Address | 22 BOSE PARA | Age | 22 Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||