Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 05085 | Date 24/11/2021 |
| Token No | SM/21-22/2054 01/02/2022 | Serial | 003 |
| Patient Name | Mrs. DISARI BHATTACHARJEE | Contact No | 9875523377 |
| Address | 113 NEHERU NAGAR COLONY | Age | 19 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||