Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 00096 | Date 06/08/2018 |
| Token No | SM/22-23/11600 14/08/2023 | Serial | 010 |
| Patient Name | Mrs. MADHUMITA GHOSH | Contact No | 9163653607 |
| Address | PANCHANAN TALA LANE | Age | 29 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||