Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 03253 | Date 21/10/2019 |
| Token No | SM/21-22/2511 23/03/2022 | Serial | 009 |
| Patient Name | Mrs. PALLABI APATA | Contact No | 8282932054 |
| Address | 44/B/5 N.L. BHATTACHARYA ST | Age | 36 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||