Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07962 | Date 16/12/2022 |
| Token No | SM/22-23/7026 16/12/2022 | Serial | 006 |
| Patient Name | Mrs. BANDANA SIL | Contact No | 8420715777 |
| Address | 18 DEY STREET | Age | 41 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||