Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 08797 | Date 21/04/2023 |
| Token No | SM/22-23/9016 21/04/2023 | Serial | 036 |
| Patient Name | Mrs. SANGITA DAS....... | Contact No | NOT GIVEN |
| Address | 100 POTUA PARA | Age | 20 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||