Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 05422 | Date 14/02/2022 |
| Token No | SM/21-22/2146 14/02/2022 | Serial | 004 |
| Patient Name | Mrs. MOUSUMI GHOSH | Contact No | 9836424408 |
| Address | 622 G T ROAD | Age | 30 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||