Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 08195 | Date 31/01/2023 |
| Token No | SM/22-23/7566 31/01/2023 | Serial | 013 |
| Patient Name | Mrs. SUMITRA DAS | Contact No | 743946421 |
| Address | 36 DOSTI LANE | Age | 44 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||