Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 07261 | Date 15/10/2022 |
| Token No | SM/22-23/5540 15/10/2022 | Serial | 002 |
| Patient Name | Mrs. GITA DAS | Contact No | NOT GIVEN |
| Address | 5/C/A SASHIBHSAN GHOSH LANE | Age | 65 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||