Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 07152 | Date 27/09/2022 |
| Token No | SM/22-23/5342 27/09/2022 | Serial | 016 |
| Patient Name | Mrs. PRIYANKA KUMARI SHAW | Contact No | 8013504486 |
| Address | 38 K. M. BHATTACHARYA ST | Age | 22 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||