Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 04805 | Date 26/08/2021 |
| Token No | SM/21-22/950 26/08/2021 | Serial | 015 |
| Patient Name | Mrs. TIYASHA MAJUMDER | Contact No | 6290857344 |
| Address | S C GHOSH LANE | Age | 30 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||