Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 09203 | Date 01/06/2023 |
| Token No | SM/22-23/9907 01/06/2023 | Serial | 015 |
| Patient Name | Mrs. PIYALI DAS | Contact No | 8902668942 |
| Address | 132 PATUAPARA | Age | 32 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||