Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04062 | Date 05/10/2020 |
| Token No | SM/21-22/1691 21/12/2021 | Serial | 006 |
| Patient Name | Mrs. BABY SRIMANI | Contact No | 9903757687 |
| Address | 2/B/2 A K C BHATTACHARJEE STREET | Age | 66 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||