Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 08002 | Date 22/12/2022 |
| Token No | SM/22-23/7115 22/12/2022 | Serial | 009 |
| Patient Name | Mrs. DAMIYANTI DEBI | Contact No | 7059631773 |
| Address | 14 DOSTI LANE | Age | 53 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||