Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07789 | Date 24/11/2022 |
| Token No | SM/22-23/6589 24/11/2022 | Serial | 003 |
| Patient Name | Mrs. SARITA DAS | Contact No | 9330302992 |
| Address | 3 DOSTI LANE | Age | 55 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||