Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 08850 | Date 25/04/2023 |
| Token No | SM/22-23/9138 25/04/2023 | Serial | 011 |
| Patient Name | Mrs. DISHA DAS | Contact No | 9477889540 |
| Address | POTUA PARA LANE | Age | 29 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||