Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08470 | Date 28/02/2023 |
| Token No | SM/22-23/8096 28/02/2023 | Serial | 015 |
| Patient Name | Mrs. SHAMPA RAJBHAR | Contact No | 8420422529 |
| Address | 10 DEY STREET | Age | 28 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||