Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05222 | Date 05/01/2022 |
| Token No | SM/21-22/1787 05/01/2022 | Serial | 002 |
| Patient Name | Miss SHIBANI MAHATO | Contact No | 8420456590 |
| Address | 5B GOPAL GANGULY LANE | Age | 5 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||