Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 08500 | Date 03/03/2023 |
| Token No | SM/22-23/8173 03/03/2023 | Serial | 006 |
| Patient Name | Mrs. CHITRA CHAKRABORTY | Contact No | 9520203762 |
| Address | 19 BAZAR BYE LANE | Age | 63 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||