Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 07581 | Date 10/11/2022 |
| Token No | SM/22-23/6161 10/11/2022 | Serial | 005 |
| Patient Name | Mrs. GITA BHARATI | Contact No | 8450821245 |
| Address | 18/149 N.L. BHATTACHARYA ST | Age | 45 Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||