Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05260 | Date 10/01/2022 |
| Token No | SM/22-23/5281 23/09/2022 | Serial | 003 |
| Patient Name | Mrs. SHYAMOLI KOLE | Contact No | 9830548529 |
| Address | 23A/1 PANCHANAN TALA LANE | Age | 52 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||