Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 07586 | Date 10/11/2022 |
| Token No | SM/22-23/6171 10/11/2022 | Serial | 015 |
| Patient Name | Mrs. MANDIRA SURUL | Contact No | 6289545847 |
| Address | 48/13 BHAGIRATHI LANE | Age | 66 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||