Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 03211 | Date 17/10/2019 |
| Token No | SM/22-23/14467 29/01/2024 | Serial | 036 |
| Patient Name | Mrs. JOLY BANERJEE | Contact No | 7044767791 |
| Address | 59A BHAGIRATHI LANE | Age | 35 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||