Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 08123 | Date 05/01/2023 |
| Token No | SM/22-23/7384 05/01/2023 | Serial | 019 |
| Patient Name | Mrs. SASWATI SHAW | Contact No | 7003876095 |
| Address | 48/12 BHAGIRATHI LANE | Age | 32 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||