Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03325 | Date 05/11/2019 |
| Token No | SM/21-22/1128 15/09/2021 | Serial | 001 |
| Patient Name | Mrs. BANALATA KUNDU | Contact No | |
| Address | Age | 66 YRS Female | |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||