Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 08367 | Date 17/02/2023 |
| Token No | SM/22-23/7909 17/02/2023 | Serial | 004 |
| Patient Name | Mrs. KALAWATI SHAW | Contact No | 8420422601 |
| Address | DEY STREET | Age | 54 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||