Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 09065 | Date 15/05/2023 |
| Token No | SM/22-23/9584 15/05/2023 | Serial | 037 |
| Patient Name | Mrs. MALATI CHAKRABORTY | Contact No | 8697822401 |
| Address | R.K. ROAD | Age | 62 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||