Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 05313 | Date 17/01/2022 |
| Token No | SM/22-23/5685 19/10/2022 | Serial | 022 |
| Patient Name | Mrs. PIYALI SENGUPTA | Contact No | 8981370684 |
| Address | 16 SITAL SARKAR LANE | Age | 60 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||