Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 11434 | Date 22/04/2024 |
| Token No | SM/24-25/16467 24/05/2024 | Serial | 003 |
| Patient Name | Mrs. KANCHAN SHA | Contact No | 6290979044 |
| Address | 130/1 Thakurbati st. | Age | 30 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||