Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 06975 | Date 07/09/2022 |
| Token No | SM/22-23/4981 07/09/2022 | Serial | 029 |
| Patient Name | Mrs. MIRA BISWAS | Contact No | NOT GIVEN |
| Address | 18/A BAISHNAB PARA 2ND LANE | Age | 81 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||