Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03226 | Date 23/11/2022 |
| Token No | SM/22-23/4663 23/11/2022 | Serial | 020 |
| Patient Name | Mrs. CHHAIDAN BEWA | Contact No | 9679618132 |
| Address | SHANTIPUR NADIA | Age | 72 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||