Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04488 | Date 14/06/2021 |
| Token No | SM/21-22/421 14/06/2021 | Serial | 019 |
| Patient Name | Mrs. SUSMITA KUNDU | Contact No | 9647012858 |
| Address | 2ND FLOOR, FLAT 204, 6 PANDIT KALINATH BHATTACHARJEE STREET | Age | 29 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||