Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 04243 | Date 06/04/2021 |
| Token No | SM/22-23/15221 13/03/2024 | Serial | 004 |
| Patient Name | Mrs. CHAITALI BISWAS | Contact No | NOT GIVEN |
| Address | 92/A DEY STREET | Age | 35 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||