Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03509 | Date 29/11/2019 |
| Token No | SM/24-25/16407 22/05/2024 | Serial | 019 |
| Patient Name | Mrs. RAJMONI MOLLICK | Contact No | NOT GIVEN |
| Address | 12 NO PITAMBAR DEY LANE | Age | 30 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||