Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 04478 | Date 14/06/2021 |
| Token No | SM/21-22/410 14/06/2021 | Serial | 008 |
| Patient Name | Mrs. BANDANA BALMIKI | Contact No | 9007812483 |
| Address | GUPTI PARA ROAD, KOLKATA | Age | 23 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||