Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 02081 | Date 17/05/2019 |
| Token No | SM/21-22/2163 16/02/2022 | Serial | 008 |
| Patient Name | Mrs. JYOTSNA BEGUM | Contact No | 9432752408 |
| Address | 13 K C BHATTACHARYA STREET | Age | 33 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||