Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 04414 | Date 25/05/2021 |
| Token No | SM/21-22/307 25/05/2021 | Serial | 003 |
| Patient Name | Mrs. SANGITA RAKSHIT | Contact No | 9883200818 |
| Address | 19/A J N LAHIRI ROAD | Age | 37 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||