Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 09177 | Date 26/05/2023 |
| Token No | SM/22-23/9830 26/05/2023 | Serial | 008 |
| Patient Name | Mrs. SIULI DAS | Contact No | 9433558741 |
| Address | 113 NO GT ROAD MANIK TOLA | Age | 41 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||