Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 08658 | Date 27/03/2023 |
| Token No | SM/22-23/8574 27/03/2023 | Serial | 021 |
| Patient Name | Mrs. BASANTI [PAL | Contact No | 8777787965 |
| Address | 44/1/E DR. N.L. BHATTACHARYA STREET | Age | 34 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||