Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 04211 | Date 31/03/2021 |
| Token No | SM/20-21/9230 31/03/2021 | Serial | 002 |
| Patient Name | Mrs. BULBUL BANERJEE | Contact No | NOT GIVEN |
| Address | 111/B J N LAHIRI ROAD | Age | 50 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||