Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 06736 | Date 16/08/2022 |
| Token No | SM/22-23/4538 16/08/2022 | Serial | 013 |
| Patient Name | Mrs. MOUMITA PAL SHIL | Contact No | 8337081455 |
| Address | 29 L M BHATTACHARJEE STREET | Age | 27 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||