Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05315 | Date 17/01/2022 |
| Token No | SM/22-23/9107 24/04/2023 | Serial | 042 |
| Patient Name | Mrs. UMA DEBI | Contact No | NOT GIVEN |
| Address | 79 DEY STREET | Age | 45 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||