Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00112 | Date 07/08/2018 |
| Token No | SM/24-25/16511 27/05/2024 | Serial | 017 |
| Patient Name | Mrs. MIRA DAS | Contact No | 8336852935 |
| Address | GHOSH PARA 1 ST LANE | Age | 61 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||