Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04832 | Date 31/08/2021 |
| Token No | SM/22-23/9923 02/06/2023 | Serial | 004 |
| Patient Name | Mrs. SANGITA DEBI | Contact No | 8910661489 |
| Address | 14/C DEY STREET | Age | 43 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||