Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05134 | Date 07/12/2021 |
| Token No | SM/21-22/1564 07/12/2021 | Serial | 006 |
| Patient Name | Miss ROHINI MUKHERJEE | Contact No | 9051723822 |
| Address | 6 CHOWDHURY PARA LANE | Age | 20 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||