Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07201 | Date 11/10/2022 |
| Token No | SM/22-23/5420 11/10/2022 | Serial | 020 |
| Patient Name | Mrs. PRITILATA JOT | Contact No | 9123625015 |
| Address | 10 DEY STREET | Age | 35 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||