Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07083 | Date 19/09/2022 |
| Token No | SM/22-23/5194 19/09/2022 | Serial | 013 |
| Patient Name | Mrs. GYANTI DEBI | Contact No | NOT GIVEN |
| Address | DEY STREET | Age | 44 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||