Ticket for Outdoor Patient
| Ward No. 15 | U-PHC No. | Registration No. 05804 | Date 06/05/2022 |
| Token No | SM/22-23/9040 21/04/2023 | Serial | 060 |
| Patient Name | Mrs. LAKKHI BANERJEE | Contact No | |
| Address | PATUA PARA | Age | 42 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||