Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 02501 | Date 18/07/2019 |
| Token No | SM/22-23/5841 26/10/2022 | Serial | 025 |
| Patient Name | Mrs. SWAPNA SIL | Contact No | NOT GIVEN |
| Address | 119 BHAGIRATHI LANE | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||