Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 08048 | Date 28/12/2022 |
| Token No | SM/22-23/7223 28/12/2022 | Serial | 020 |
| Patient Name | Mrs. MINA RANI DEY | Contact No | 8017198342 |
| Address | 7D 2ND BYE LANE SASHI BHUSAN GHOSH LANE | Age | 64 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||