Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 05329 | Date 20/01/2022 |
| Token No | SM/22-23/2675 07/04/2022 | Serial | 004 |
| Patient Name | Mrs. MALA KUNDU | Contact No | 9831197166 |
| Address | 329/B NITYA GOPAL DAS LANE | Age | 49 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||