Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 05932 | Date 24/05/2022 |
| Token No | SM/22-23/3097 24/05/2022 | Serial | 036 |
| Patient Name | Mrs. MINA CHOWDHURY | Contact No | NOT GIVEN |
| Address | 14B ASHUTOSH CHATTERJEE LANE | Age | 56 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||