Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 08084 | Date 02/01/2023 |
| Token No | SM/22-23/7306 02/01/2023 | Serial | 005 |
| Patient Name | Mrs. SUMANA DEY | Contact No | 8617511154 |
| Address | 1 DEY STREET | Age | 45 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||