Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 10304 | Date 04/09/2023 |
| Token No | SM/24-25/16517 28/05/2024 | Serial | 005 |
| Patient Name | Mrs. FULWA BHUIYA | Contact No | 6290001541 |
| Address | JITEN LAHIRI ROAD | Age | 31 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||