Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02160 | Date 03/06/2019 |
| Token No | SM/21-22/209 04/05/2021 | Serial | 007 |
| Patient Name | Mrs. TULI DEY | Contact No | |
| Address | 5E GOPAL GANGULY LANE | Age | 38 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||