Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 05966 | Date 30/05/2022 |
| Token No | SM/22-23/3163 30/05/2022 | Serial | 002 |
| Patient Name | Mrs. SAMPA SARKAR | Contact No | 9874380848 |
| Address | 10/T DOCTOR BAGAN LANE | Age | 33 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||