Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 05919 | Date 24/05/2022 |
| Token No | SM/22-23/3084 24/05/2022 | Serial | 023 |
| Patient Name | Miss RITTIKA HALDER | Contact No | NOT GIVEN |
| Address | 55/D THAKURBATI STREET | Age | 17 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||