Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 04496 | Date 14/06/2021 |
| Token No | SM/21-22/429 14/06/2021 | Serial | 027 |
| Patient Name | Mrs. MRIDULA GHATAK | Contact No | 9432061122 |
| Address | 74/B J N LAHIRI ROAD | Age | 58 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||