Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 05524 | Date 11/03/2022 |
| Token No | SM/22-23/6109 09/11/2022 | Serial | 002 |
| Patient Name | Mrs. SHILA CHAKRABORTY | Contact No | NOT GIVEN |
| Address | BHAGIRATHI LANE | Age | 71 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||