Ticket for Outdoor Patient
| Ward No. 16 | U-PHC No. | Registration No. 06566 | Date 30/07/2022 |
| Token No | SM/22-23/4206 30/07/2022 | Serial | 003 |
| Patient Name | Mrs. MOUSUMI BANERJEE | Contact No | 8697434098 |
| Address | 12/2/1 NILMONI GHOSH LANE | Age | 25 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||