Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04859 | Date 01/09/2021 |
| Token No | SM/22-23/3328 10/06/2022 | Serial | 006 |
| Patient Name | Mrs. LAKKHI NANDI | Contact No | NOT GIVEN |
| Address | BANERJEE PARA | Age | 80 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||