Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05796 | Date 05/05/2022 |
| Token No | SM/22-23/2891 05/05/2022 | Serial | 030 |
| Patient Name | Mrs. LAKKHI BANERJEE | Contact No | 9874521048 |
| Address | 20 R B SARANI | Age | 56 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||