Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 07120 | Date 23/09/2022 |
| Token No | SM/22-23/5289 23/09/2022 | Serial | 011 |
| Patient Name | Mrs. RINA CHAKRABORTY | Contact No | 7439554303 |
| Address | 39 J N LAHIRI ROAD | Age | 52 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||