Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03914 | Date 14/03/2020 |
| Token No | SM/21-22/703 23/07/2021 | Serial | 013 |
| Patient Name | Mrs. CHITRALEKHA CHOWDHURY | Contact No | 6290736685 |
| Address | CHOWDHURY PARA LANE | Age | 72 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||