Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 06771 | Date 17/08/2022 |
| Token No | SM/22-23/4590 17/08/2022 | Serial | 022 |
| Patient Name | Mrs. SANDHYA BASAK | Contact No | 9088916350 |
| Address | 2/263 G T ROAD | Age | 44 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||