Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 06030 | Date 08/06/2022 |
| Token No | SM/25-26/701 09/06/2025 | Serial | 017 |
| Patient Name | Mrs. MIRA DAS | Contact No | 9831864965 |
| Address | 538 G T ROAD | Age | 54 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||