Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05075 | Date 24/11/2021 |
| Token No | SM/21-22/1453 24/11/2021 | Serial | 002 |
| Patient Name | Mrs. MINA MONDAL | Contact No | 9477429838 |
| Address | N L BHATTACHARJEE STREET | Age | 48 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||