Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03932 | Date 18/03/2020 |
| Token No | SM/22-23/4465 11/08/2022 | Serial | 001 |
| Patient Name | Mrs. KAJOL SHAW | Contact No | NOT GIVEN |
| Address | T.P. BHATTACHARYA ST | Age | 21 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||