Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05372 | Date 31/01/2022 |
| Token No | SM/21-22/2051 31/01/2022 | Serial | 015 |
| Patient Name | Miss PREMA GUPTA | Contact No | 6290666199 |
| Address | DR, NANILAL BHATTACHARJEE STREET | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||