Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 04543 | Date 29/06/2021 |
| Token No | SM/24-25/19581 05/11/2024 | Serial | 011 |
| Patient Name | Mrs. MAMATA DAS | Contact No | NOT GIVEN |
| Address | BOSEPARA | Age | 43 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||