Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 04389 | Date 13/05/2021 |
| Token No | SM/21-22/2358 08/03/2022 | Serial | 024 |
| Patient Name | Mrs. SOMA CHATTERJEE | Contact No | 7449894738 |
| Address | 77 JITEN LAHIRI ROAD | Age | 57 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||