Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 06746 | Date 16/08/2022 |
| Token No | SM/22-23/4551 16/08/2022 | Serial | 026 |
| Patient Name | Mrs. TANIMA DALAL | Contact No | 8961448685 |
| Address | NILMONI GHOSH LANE | Age | 36 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||