Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 09179 | Date 26/05/2023 |
| Token No | SM/22-23/9833 26/05/2023 | Serial | 011 |
| Patient Name | Mrs. KUMKUM BANERJEE | Contact No | 8001548520 |
| Address | 65 DEY STREET FLAT 204 | Age | 29 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||