Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 11409 | Date 15/04/2024 |
| Token No | SM/24-25/16466 24/05/2024 | Serial | 002 |
| Patient Name | Mrs. DOYEL PAL | Contact No | 9748202831 |
| Address | 127 POTUA PARA LANE | Age | 26 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||