Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 08539 | Date 14/03/2023 |
| Token No | SM/22-23/8271 14/03/2023 | Serial | 007 |
| Patient Name | Mrs. PUTUL DAS | Contact No | NOT GIVEN |
| Address | BIBIR BER | Age | 58 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||