Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05352 | Date 27/01/2022 |
| Token No | SM/24-25/20585 18/01/2025 | Serial | 007 |
| Patient Name | Miss ROSHINI DAS | Contact No | 9883670314 |
| Address | 78 DEY STREET | Age | 21 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||