Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04848 | Date 01/09/2021 |
| Token No | SM/22-23/8332 16/03/2023 | Serial | 004 |
| Patient Name | Miss PUNAM KUMARI | Contact No | 9432982164 |
| Address | 12 PITAMBAR DEY LANE | Age | 19 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||