Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04142 | Date 04/05/2023 |
| Token No | SM/22-23/8614 04/05/2023 | Serial | 034 |
| Patient Name | Mrs. AMENA KHATOON | Contact No | 9903257497 |
| Address | 18/A MIA JAN DARJI LANE SERAMPORE 712203 | Age | 30 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||