Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 08637 | Date 24/03/2023 |
| Token No | SM/22-23/8525 24/03/2023 | Serial | 004 |
| Patient Name | Mrs. MENOKA KOLEY | Contact No | 9874070535 |
| Address | 39A/2 S B GHOSH LANE | Age | 75 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||