Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04010 | Date 14/08/2020 |
| Token No | SM/25-26/275 28/04/2025 | Serial | 003 |
| Patient Name | Mrs. RITA DAS | Contact No | 8017058152 |
| Address | 90C/1 DEY STREET | Age | 45 yrs Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||