Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04738 | Date 16/08/2021 |
| Token No | SM/21-22/853 16/08/2021 | Serial | 017 |
| Patient Name | Mrs. KUHELI KUNDU | Contact No | NOT GIVEN |
| Address | 5C BECHU DEY LANE | Age | 39 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||