Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 04781 | Date 23/08/2021 |
| Token No | SM/21-22/910 23/08/2021 | Serial | 005 |
| Patient Name | Mrs. MOUSUMI SEN | Contact No | 9836424408 |
| Address | 622 G T ROADB BAT TALA | Age | 30 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||