Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05858 | Date 17/05/2022 |
| Token No | SM/22-23/2992 17/05/2022 | Serial | 018 |
| Patient Name | Mrs. SANCHARI GHOSH | Contact No | 7003410770 |
| Address | 14/2 J.N.M LANE, CHAMPDANI, BAIDYABATI, 712222 | Age | 31 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||