Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 04356 | Date 05/05/2021 |
| Token No | SM/21-22/378 08/06/2021 | Serial | 008 |
| Patient Name | Mrs. ARPITA KARMAKAR | Contact No | 7439647759 |
| Address | 105 J N LAHIRI ROAD | Age | 25 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||