Ticket for Outdoor Patient
| Ward No. 21 | U-PHC No. | Registration No. 07050 | Date 15/09/2022 |
| Token No | SM/22-23/5143 15/09/2022 | Serial | 024 |
| Patient Name | Mrs. GAYETRI DUTTA | Contact No | 9051171792 |
| Address | BAISNAB PARA 1ST LANE | Age | 57 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||