Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 05847 | Date 17/05/2022 |
| Token No | SM/22-23/2981 17/05/2022 | Serial | 007 |
| Patient Name | Mrs. KUMKUM SAHA.. | Contact No | 6290192677 |
| Address | 16/I SITAL SARKAR LANE | Age | 36 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||