Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01339 | Date 06/12/2018 |
| Token No | SM/21-22/94 19/04/2021 | Serial | 007 |
| Patient Name | Mrs. ANSARI BEGUM | Contact No | NOT GIVEN |
| Address | 26 k c bhattacharjee street | Age | 52 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||