Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04524 | Date 23/06/2021 |
| Token No | SM/21-22/478 23/06/2021 | Serial | 008 |
| Patient Name | Mrs. CHHAYA MUKHERJEE | Contact No | NOT GIVEN |
| Address | 5 CHATTERJEE LANE | Age | 43 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||