Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 08076 | Date 30/12/2022 |
| Token No | SM/22-23/7286 30/12/2022 | Serial | 016 |
| Patient Name | Mrs. SHIPRA DAS | Contact No | 8420794148 |
| Address | 40/C BARA BAGAN LANE | Age | 75 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||