Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 06109 | Date 16/06/2022 |
| Token No | SM/22-23/3425 16/06/2022 | Serial | 001 |
| Patient Name | Mrs. MONALISHA DAS GUPTA | Contact No | 8617747339 |
| Address | 60 J.N. LAHIRI ROAD | Age | 36 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||