Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01483 | Date 20/12/2018 |
| Token No | SM/22-23/8395 20/03/2023 | Serial | 010 |
| Patient Name | Mrs. PURNIMA DAS | Contact No | NOT GIVEN |
| Address | MAHESH | Age | 50 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||