Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04837 | Date 31/08/2021 |
| Token No | SM/21-22/1008 31/08/2021 | Serial | 030 |
| Patient Name | Mrs. SUMANA MUKHERJEE | Contact No | 9007629528 |
| Address | 13 CHATTERJEE LANE | Age | 39 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||