Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 04418 | Date 01/06/2021 |
| Token No | SM/21-22/312 01/06/2021 | Serial | 001 |
| Patient Name | Mrs. JKRISHNA MUKHERJEE | Contact No | 9674506692 |
| Address | 101A N N COLONY | Age | 57 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||