Ticket for Outdoor Patient
| Ward No. 8 | U-PHC No. | Registration No. 07996 | Date 21/12/2022 |
| Token No | SM/22-23/7089 21/12/2022 | Serial | 010 |
| Patient Name | Mrs. JYOTSNA DAS | Contact No | NOT GIVEN |
| Address | K M SHA STREET | Age | 30 Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||