Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 04528 | Date 24/06/2021 |
| Token No | SM/21-22/488 24/06/2021 | Serial | 005 |
| Patient Name | Mrs. SRATASWINI DUTTA | Contact No | NOT GIVEN |
| Address | CHATRA BARUIPARA | Age | 21 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||