Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04053 | Date 25/09/2020 |
| Token No | SM/21-22/119 20/04/2021 | Serial | 013 |
| Patient Name | Miss NEHA KUMARI.. | Contact No | 9062375128 |
| Address | 30 NANILAL BHATTACHARJEE STREET | Age | 21 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||