Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00134 | Date 08/08/2018 |
| Token No | SM/22-23/8542 25/03/2023 | Serial | 004 |
| Patient Name | Mrs. MADHUMITA SAMANTA | Contact No | 9830857411 |
| Address | DEY STREET | Age | 42 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||