Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01224 | Date 30/10/2018 |
| Token No | SM/22-23/8949 18/04/2023 | Serial | 010 |
| Patient Name | Mrs. SUPRIYA DAS | Contact No | 9051756083 |
| Address | 36/37A R B SARANI | Age | 51 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||