Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 07644 | Date 14/11/2022 |
| Token No | SM/22-23/8521 23/03/2023 | Serial | 032 |
| Patient Name | Mrs. PANBATI DEVI | Contact No | NOT GIVEN |
| Address | 1 DEY GHAT LANE | Age | 71 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||