Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 07346 | Date 21/10/2022 |
| Token No | SM/22-23/5702 21/10/2022 | Serial | 002 |
| Patient Name | Mrs. SANDIPA PAL | Contact No | 8777611554 |
| Address | 119 G T ROAD | Age | 54 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||