Ticket for Outdoor Patient
| Ward No. 18 | U-PHC No. | Registration No. 04886 | Date 07/09/2021 |
| Token No | SM/22-23/3877 18/07/2022 | Serial | 012 |
| Patient Name | Mrs. UMA BHATTACHARYA | Contact No | NOT GIVEN |
| Address | 113 N.N. COLONY | Age | 42 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||