Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 11165 | Date 20/02/2024 |
| Token No | SM/22-23/14819 20/02/2024 | Serial | 028 |
| Patient Name | Mrs. BINA CHAKRABORTY | Contact No | |
| Address | Age | 54 YRS Female | |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||