Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 05961 | Date 27/05/2022 |
| Token No | SM/22-23/3155 27/05/2022 | Serial | 019 |
| Patient Name | Mrs. KAMALIKA RAKSHIT | Contact No | NOT GIVEN |
| Address | 49 POTUA PARA LANE | Age | 29 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||