Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09337 | Date 14/06/2023 |
| Token No | SM/22-23/10182 14/06/2023 | Serial | 004 |
| Patient Name | Miss NISHA KUMARI | Contact No | 8100501455 |
| Address | 1 L M BHATTACHARHJEE STREET | Age | 20 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||