Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 04110 | Date 02/12/2020 |
| Token No | SM/22-23/7670 03/02/2023 | Serial | 009 |
| Patient Name | Mrs. GITA BHATTACHRYA | Contact No | NOT GIVEN |
| Address | 68 THAKUR BATI STREET | Age | 73 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||