Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 05954 | Date 27/05/2022 |
| Token No | SM/22-23/3139 27/05/2022 | Serial | 003 |
| Patient Name | Mrs. SIBANI NATH | Contact No | 9831132602 |
| Address | 18/B/1 KAILASH CHATTERJEE LANE | Age | 28 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||