Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 03191 | Date 15/10/2019 |
| Token No | SM/21-22/773 05/08/2021 | Serial | 004 |
| Patient Name | Miss NEHA RAM | Contact No | 6291626680 |
| Address | 2 GOPAL GANGULY LANE | Age | 24 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||