Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05699 | Date 19/04/2022 |
| Token No | SM/22-23/2712 19/04/2022 | Serial | 003 |
| Patient Name | Mrs. PARBATI KUNDU | Contact No | NOT GIVEN |
| Address | 9 KASHI DAKTAR LANE | Age | 71 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||