Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03935 | Date 18/03/2020 |
| Token No | SM/22-23/4468 11/08/2022 | Serial | 004 |
| Patient Name | Mrs. BASANTI DAS | Contact No | 8017781930 |
| Address | 79B DEY STREET | Age | 37 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||