Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01698 | Date 21/02/2019 |
| Token No | SM/22-23/10760 10/07/2023 | Serial | 012 |
| Patient Name | Mrs. USHA DEBI | Contact No | 6290161239 |
| Address | 17/C N L BHATTACHARJEE STREET | Age | 47 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||