Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 00420 | Date 30/08/2018 |
| Token No | SM/22-23/8461 22/03/2023 | Serial | 008 |
| Patient Name | Mrs. RUNI PAL | Contact No | 8777787965 |
| Address | 44/1/E N.L. BHATTACHARYA STREET | Age | 31 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||