Ticket for Outdoor Patient
| Ward No. 23 | U-PHC No. | Registration No. 09105 | Date 18/05/2023 |
| Token No | SM/22-23/9661 18/05/2023 | Serial | 021 |
| Patient Name | Mrs. GULMOHAR KOSTA | Contact No | NOT GIVEN |
| Address | GANGULY BAGAN | Age | 66 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||