Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 04990 | Date 26/10/2021 |
| Token No | SM/21-22/1281 26/10/2021 | Serial | 005 |
| Patient Name | Mrs. KALYANI GHOSH | Contact No | 7890919191 |
| Address | 37B J N LAHIRI ROAD | Age | 38 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||