Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 04846 | Date 01/09/2021 |
| Token No | SM/22-23/13853 18/12/2023 | Serial | 004 |
| Patient Name | Mrs. HENA MONDAL | Contact No | NOT GIVEN |
| Address | 40/A SASHI BHUSAN GHOSH LANE | Age | 65 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||