Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 08914 | Date 28/04/2023 |
| Token No | SM/22-23/9251 28/04/2023 | Serial | 013 |
| Patient Name | Mrs. RUPASHREE MAKAL | Contact No | 9433887941 |
| Address | POTUA PARA LANE | Age | 38 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||