Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 05889 | Date 23/05/2022 |
| Token No | SM/22-23/8387 20/03/2023 | Serial | 002 |
| Patient Name | Mrs. SUSHAMA BANERJEE | Contact No | 9233578565 |
| Address | 36 R B SARANI | Age | 48 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||