Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03311 | Date 31/10/2019 |
| Token No | SM/22-23/6935 12/12/2022 | Serial | 010 |
| Patient Name | Mrs. RUPA DAS | Contact No | 6291982851 |
| Address | 79 DEY STREET | Age | 28 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||