Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 06095 | Date 14/06/2022 |
| Token No | SM/22-23/3398 14/06/2022 | Serial | 018 |
| Patient Name | Mrs. PRIYANKA KUMARI SHAW | Contact No | NOT GIVEN |
| Address | 38 K.M BHATTACHARJEE ST | Age | 22 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||