Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 04720 | Date 13/08/2021 |
| Token No | SM/21-22/829 13/08/2021 | Serial | 002 |
| Patient Name | Mrs. JYOTSNA BEGUM | Contact No | 6290383025 |
| Address | K C BHATTACHARJEE STREET | Age | 29 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||