Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 04989 | Date 26/10/2021 |
| Token No | SM/21-22/1279 26/10/2021 | Serial | 003 |
| Patient Name | Mrs. GANGA BERA | Contact No | 7439943114 |
| Address | 98 J N LAHIRI ROAD | Age | 28 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||