Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05571 | Date 22/03/2022 |
| Token No | SM/22-23/4165 28/07/2022 | Serial | 027 |
| Patient Name | Mrs. MAYA BASAK | Contact No | NOT GIVEN |
| Address | BSNL OFFICE STAFF | Age | 44 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||