Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04344 | Date 28/04/2021 |
| Token No | SM/22-23/3540 22/06/2022 | Serial | 003 |
| Patient Name | Mrs. RINA SENGUPTA | Contact No | 9331298340 |
| Address | INDIA JUTE MILL | Age | 65 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||