Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 09249 | Date 05/06/2023 |
| Token No | SM/22-23/9984 05/06/2023 | Serial | 031 |
| Patient Name | Mrs. JUTHIKA BANERJEE | Contact No | NOT GIVEN |
| Address | 40 PANDIT KALINATH BHATTACHARYA STREET | Age | 75 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||