Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05853 | Date 17/05/2022 |
| Token No | SM/22-23/2987 17/05/2022 | Serial | 013 |
| Patient Name | Mrs. RINA DEY.. | Contact No | 6289549337 |
| Address | 5B/2 GOPAL GANGULY LANE | Age | 53 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||