Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 02158 | Date 03/06/2019 |
| Token No | SM/21-22/139 21/04/2021 | Serial | 013 |
| Patient Name | Mrs. ILA PAL | Contact No | 9163219812 |
| Address | 2B KAILASH CHATTERJEE LANE | Age | 63 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||