Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 05537 | Date 15/03/2022 |
| Token No | SM/21-22/2427 15/03/2022 | Serial | 005 |
| Patient Name | Mrs. SITA SHA | Contact No | 9874355995 |
| Address | 5 K M BHATTACHARJEE STREET | Age | 58 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||