Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05918 | Date 24/05/2022 |
| Token No | SM/22-23/8592 27/03/2023 | Serial | 039 |
| Patient Name | Mrs. SULATA BISWAS BANIK | Contact No | 9830833886 |
| Address | 2 LAL BAHADUR SHASTRI ROAD | Age | 40 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||