Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 07670 | Date 15/11/2022 |
| Token No | SM/22-23/6329 15/11/2022 | Serial | 016 |
| Patient Name | Miss KOUSHIKI MONDAL | Contact No | 9123691742 |
| Address | 39B SASHI BHUSAN GHOSH LANE | Age | 11 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||