Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 07329 | Date 19/10/2022 |
| Token No | SM/22-23/5664 19/10/2022 | Serial | 001 |
| Patient Name | Miss SUDIPTA ROY | Contact No | NOT GIVEN |
| Address | 134/3 THAKUR BATI STREET | Age | 22 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||