Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 07048 | Date 15/09/2022 |
| Token No | SM/22-23/5140 15/09/2022 | Serial | 021 |
| Patient Name | Mrs. KUSUM RAY | Contact No | NOT GIVEN |
| Address | 22 BOSE PARA | Age | 58 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||