Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 03290 | Date 24/10/2019 |
| Token No | SM/22-23/5585 17/10/2022 | Serial | 039 |
| Patient Name | Mrs. KALYANI DAS | Contact No | 9062384211 |
| Address | 9 PATUA PARA LANE | Age | 65 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||