Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05560 | Date 21/03/2022 |
| Token No | SM/21-22/2470 21/03/2022 | Serial | 005 |
| Patient Name | Mrs. FATEMA BIBI. | Contact No | 9903275143 |
| Address | 55 NANILAL BHATTACHARJEE STREET | Age | 40 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||