Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 01928 | Date 16/04/2019 |
| Token No | SM/21-22/374 08/06/2021 | Serial | 004 |
| Patient Name | Miss SUBHRA BANERJEE | Contact No | NOT GIVEN |
| Address | 17 BHAGIRATHI LANE | Age | 65 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||