Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 06729 | Date 13/08/2022 |
| Token No | SM/22-23/4523 13/08/2022 | Serial | 012 |
| Patient Name | Mrs. BASANTI SAHA | Contact No | NOT GIVEN |
| Address | 79B DEY STREET | Age | 50 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||