Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04733 | Date 16/08/2021 |
| Token No | SM/21-22/848 16/08/2021 | Serial | 012 |
| Patient Name | Mrs. MANJU HELA | Contact No | 8583090047 |
| Address | 35/18 N L BHATTACHARJEE STREET | Age | 42 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||