Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 01686 | Date 19/02/2019 |
| Token No | SM/22-23/6639 25/11/2022 | Serial | 018 |
| Patient Name | Mrs. MAMATA BARIK | Contact No | 8584948804 |
| Address | 44/1/C DR. N.L BHATTACHARYA ST | Age | 37 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||