Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 07033 | Date 14/09/2022 |
| Token No | SM/22-23/5110 14/09/2022 | Serial | 009 |
| Patient Name | Mrs. RUPA SHAW | Contact No | 9038866229 |
| Address | 2 LOLIT MOHAN BHATTACHARYA ST | Age | 26 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||