Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02641 | Date 29/07/2019 |
| Token No | SM/24-25/15800 18/04/2024 | Serial | 012 |
| Patient Name | Miss SUPRIYA JAYSWARA | Contact No | 9875650744 |
| Address | 7NO DEY GHAT LANE | Age | 21 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||