Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05777 | Date 05/05/2022 |
| Token No | SM/22-23/2934 11/05/2022 | Serial | 009 |
| Patient Name | Mrs. MANJULA SHAW | Contact No | 7438962518 |
| Address | 2 LALIT MOHON BHATTACHARJEE STREET | Age | 39 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||