Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 07931 | Date 12/12/2022 |
| Token No | SM/22-23/6943 12/12/2022 | Serial | 018 |
| Patient Name | Mrs. ALPANA ROY.. | Contact No | NOT GIVEN |
| Address | 40 THAKURBATI STREET | Age | 56 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||