Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 02018 | Date 02/05/2019 |
| Token No | SM/21-22/738 28/07/2021 | Serial | 006 |
| Patient Name | Mrs. URMILA RAM | Contact No | NOT GIVEN |
| Address | 2 GOPAL GANGULY LANE | Age | 51 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||