Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 07249 | Date 14/10/2022 |
| Token No | SM/22-23/12803 29/09/2023 | Serial | 003 |
| Patient Name | Miss MOUMITA SASMAL | Contact No | 9903298513 |
| Address | 40/1 BHAGIRATHI LANE | Age | 20 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||