Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 06195 | Date 23/06/2022 |
| Token No | SM/22-23/3558 23/06/2022 | Serial | 005 |
| Patient Name | Mrs. MOUMITA NANDI | Contact No | NOT GIVEN |
| Address | NANDI MATH, SERAMPORE | Age | 29 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||