Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05448 | Date 18/02/2022 |
| Token No | SM/21-22/2192 18/02/2022 | Serial | 006 |
| Patient Name | Mrs. SANGITA MITRA | Contact No | 9874845285 |
| Address | 17 DEY STREET | Age | 61 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||