Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 09173 | Date 24/05/2023 |
| Token No | SM/22-23/9814 24/05/2023 | Serial | 016 |
| Patient Name | Mrs. SHIPRA PRAMANIK | Contact No | NOT GIVEN |
| Address | 140 N.N. COLONY | Age | 62 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||