Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 07139 | Date 26/09/2022 |
| Token No | SM/22-23/5320 26/09/2022 | Serial | 017 |
| Patient Name | Miss SATHI KOLAY | Contact No | 7605829475 |
| Address | 39 S B GHOSH LANE | Age | 15 Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||