Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05530 | Date 14/03/2022 |
| Token No | SM/21-22/2402 14/03/2022 | Serial | 004 |
| Patient Name | Mrs. MALABIKA CHAKRABORTY | Contact No | 9477030566 |
| Address | 1/2 CHATTERJEE LANE | Age | 51 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||