Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 06973 | Date 07/09/2022 |
| Token No | SM/22-23/4979 07/09/2022 | Serial | 027 |
| Patient Name | Mrs. PURNIMA SARKAR | Contact No | NOT GIVEN |
| Address | 5/27 BAISHNAB PARA 1ST LANE | Age | 31 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||