Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 09069 | Date 16/05/2023 |
| Token No | SM/22-23/9596 16/05/2023 | Serial | 010 |
| Patient Name | Mrs. SIBANI MADHU | Contact No | NOT GIVEN |
| Address | 31 SASHI BHUSHAN GHOSH LANE | Age | 26 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||