Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00096 | Date 06/08/2018 |
| Token No | SM/21-22/1430 23/11/2021 | Serial | 002 |
| Patient Name | Mrs. MADHUMITA GHOSH | Contact No | 9163653607 |
| Address | PANCHANAN TALA LANE | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||