Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04860 | Date 01/09/2021 |
| Token No | SM/22-23/4364 05/08/2022 | Serial | 013 |
| Patient Name | Mrs. MAYA NANDI | Contact No | 9830598667 |
| Address | BANERJEE PARA | Age | 51 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||