Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 01640 | Date 23/05/2022 |
| Token No | SM/22-23/65 23/05/2022 | Serial | 034 |
| Patient Name | Mrs. MAYA DEBI | Contact No | |
| Address | 50 KRISHNANAGAR NAYA BASTI RISHRA | Age | 40 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||