Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 06716 | Date 12/08/2022 |
| Token No | SM/22-23/4501 12/08/2022 | Serial | 010 |
| Patient Name | Mrs. NANDITA BANIK | Contact No | 9477852589 |
| Address | 29 DHARMATALA LANE | Age | 49 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||