Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 07077 | Date 19/09/2022 |
| Token No | SM/22-23/7357 04/01/2023 | Serial | 020 |
| Patient Name | Mrs. KAMLAWATI DEBI | Contact No | 8420496341 |
| Address | 4 DEY GHAT LANE | Age | 40 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||