Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 06747 | Date 16/08/2022 |
| Token No | SM/22-23/4552 16/08/2022 | Serial | 027 |
| Patient Name | Miss NANDINI DALAL | Contact No | NOT GIVEN |
| Address | NILMONI GHOSH LANE | Age | 20 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||