Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 10003 | Date 18/08/2023 |
| Token No | SM/22-23/11705 18/08/2023 | Serial | 005 |
| Patient Name | Mrs. CHAMPA GHOSH | Contact No | 8981910717 |
| Address | 535 G T ROAD | Age | 53 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||