Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 06085 | Date 14/06/2022 |
| Token No | SM/22-23/3382 14/06/2022 | Serial | 002 |
| Patient Name | Mrs. TULTULI CHAKROBARTY | Contact No | 9674859800 |
| Address | THAKUR BATI STREET | Age | 46 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||