Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 07719 | Date 18/11/2022 |
| Token No | SM/22-23/6441 18/11/2022 | Serial | 012 |
| Patient Name | Mrs. SHANTI GOSWAMI | Contact No | NOT GIVEN |
| Address | 39 LBS ROAD | Age | 22 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||