Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 07538 | Date 07/11/2022 |
| Token No | SM/22-23/6064 07/11/2022 | Serial | 014 |
| Patient Name | Mrs. BISAKHA DIG | Contact No | NOT GIVEN |
| Address | 42 BHAGIRATHI LANE | Age | 62 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||