Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04621 | Date 16/07/2021 |
| Token No | SM/21-22/647 16/07/2021 | Serial | 004 |
| Patient Name | Mrs. GOURI CHATTERJEE | Contact No | 9836706431 |
| Address | 16/A PANCHANAN TALA LANE | Age | 65 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||