Ticket for Outdoor Patient
| Ward No. 13 | U-PHC No. | Registration No. 05652 | Date 04/04/2022 |
| Token No | SM/22-23/2620 04/04/2022 | Serial | 026 |
| Patient Name | Miss PRIYANTI GANGULY | Contact No | NOT GIVEN |
| Address | 21A/2 CHOWDHURY PARA | Age | 5 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||