Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 00654 | Date 11/09/2018 |
| Token No | SM/22-23/6467 21/11/2022 | Serial | 007 |
| Patient Name | Mrs. CHANDA KHATIK | Contact No | NOT GIVEN |
| Address | PAL BAGAN DEY STREET | Age | 59 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||