Ticket for Outdoor Patient
| Ward No. 9 | U-PHC No. | Registration No. 06543 | Date 28/07/2022 |
| Token No | SM/22-23/4168 28/07/2022 | Serial | 030 |
| Patient Name | Mrs. GOURI BISWAS | Contact No | NOT GIVEN |
| Address | 8 BAZAR BYE LANE | Age | 50 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||