Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04735 | Date 16/08/2021 |
| Token No | SM/21-22/850 16/08/2021 | Serial | 014 |
| Patient Name | Mrs. P BHABANI | Contact No | 8910570296 |
| Address | 18/44 N L BHATTACHARJEE STREET | Age | 23 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||