Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02178 | Date 04/06/2019 |
| Token No | SM/24-25/18176 14/08/2024 | Serial | 011 |
| Patient Name | Mrs. KRISHNA DEY | Contact No | 8017744624 |
| Address | 75 DEY STREET | Age | 35 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||