Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 08330 | Date 13/02/2023 |
| Token No | SM/22-23/7838 13/02/2023 | Serial | 004 |
| Patient Name | Mrs. DIPALI PAL | Contact No | 6290026465 |
| Address | 4/A POTUA PARA LANE | Age | 49 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||