Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04637 | Date 19/07/2021 |
| Token No | SM/21-22/677 19/07/2021 | Serial | 020 |
| Patient Name | Mrs. REBA MAJUMDER | Contact No | NOT GIVEN |
| Address | 41 DR. NANILAL BHATTACGHARJEE STREET | Age | 52 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||