Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 07063 | Date 16/09/2022 |
| Token No | SM/22-23/5166 16/09/2022 | Serial | 009 |
| Patient Name | Mrs. SULATA MAHATO | Contact No | NOT GIVEN |
| Address | KAILASH CHATTERJEE LANE | Age | 46 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||