Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 01708 | Date 22/02/2019 |
| Token No | SM/21-22/257 13/05/2021 | Serial | 003 |
| Patient Name | Mrs. ANNA SARKAR | Contact No | 6290148295 |
| Address | 17 KAILASH CHATTERJEE LANE | Age | 63 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||