Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03581 | Date 09/12/2019 |
| Token No | SM/21-22/2345 08/03/2022 | Serial | 011 |
| Patient Name | Miss TANUSHREE RAKSHIT | Contact No | 9674453812 |
| Address | 47 LALIT MOHON BHATTACHARYA STREET | Age | 14 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||