Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 05529 | Date 14/03/2022 |
| Token No | SM/21-22/2401 14/03/2022 | Serial | 003 |
| Patient Name | Mrs. SHIPRA CHAKRABORTY.. | Contact No | NOT GIVEN |
| Address | 62/A THAKUR BATI STREET | Age | 74 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||