Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 06722 | Date 13/08/2022 |
| Token No | SM/22-23/4516 13/08/2022 | Serial | 005 |
| Patient Name | Mrs. NAMITA PODDAR | Contact No | 7044859685 |
| Address | 78/2 BAISHNAB PARA 2ND LANE | Age | 36 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||