Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 05148 | Date 14/12/2021 |
| Token No | SM/21-22/1612 14/12/2021 | Serial | 003 |
| Patient Name | Mrs. TARA BHATTACHARJEE | Contact No | 9239258259 |
| Address | 181 N N COLONY | Age | 59 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||