Ticket for Outdoor Patient
| Ward No. 11 | U-PHC No. | Registration No. 05979 | Date 31/05/2022 |
| Token No | SM/22-23/8779 10/04/2023 | Serial | 003 |
| Patient Name | Mrs. HIMANI DEY | Contact No | 9874257391 |
| Address | 11 RAJ MOHON GOSWAMI LANE | Age | 76 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||