Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 07491 | Date 03/11/2022 |
| Token No | SM/25-26/5607 27/08/2026 | Serial | 013 |
| Patient Name | Mrs. JHARNA KOLEY | Contact No | NOT GIVEN |
| Address | 23/1 A B GARDEN LANE | Age | 65 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||