Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00658 | Date 11/09/2018 |
| Token No | SM/22-23/8635 30/03/2023 | Serial | 007 |
| Patient Name | Miss RASHMITA SAMON | Contact No | 9339830034 |
| Address | 21 CHOWDHURI PARA LANE | Age | 23 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||