Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05867 | Date 14/12/2023 |
| Token No | SM/22-23/16494 14/12/2023 | Serial | 003 |
| Patient Name | Mrs. SUBARNA DEWAN | Contact No | |
| Address | PANDUA KHANAN | Age | 45 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||