Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 04920 | Date 24/09/2021 |
| Token No | SM/21-22/1153 24/09/2021 | Serial | 004 |
| Patient Name | Mrs. BANA BANERJEE | Contact No | NOT GIVEN |
| Address | 164B N N COLONY | Age | 37 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||