Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 07080 | Date 19/09/2022 |
| Token No | SM/22-23/5189 19/09/2022 | Serial | 008 |
| Patient Name | Mrs. MOUSUMI SABUI | Contact No | 9674099096 |
| Address | 52/1B/1 BHAGIRATHI LANE | Age | 50 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||