Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 03978 | Date 06/07/2020 |
| Token No | SM/21-22/465 22/06/2021 | Serial | 006 |
| Patient Name | Mrs. KANANBALA DAS | Contact No | NOT GIVEN |
| Address | TALPUKUR LOKENATH PALLY | Age | 41 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||