Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 10176 | Date 28/08/2023 |
| Token No | SM/22-23/12042 28/08/2023 | Serial | 044 |
| Patient Name | Mrs. DOLAN BISWAS | Contact No | 9674808302 |
| Address | 123/A THAKURBATI STREET | Age | 65 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||