Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 05872 | Date 18/05/2022 |
| Token No | SM/22-23/3008 18/05/2022 | Serial | 007 |
| Patient Name | Mrs. CHHAYA RAKSHIT | Contact No | 8145626832 |
| Address | 51I J N LAHIRI ROAD | Age | 75 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||