Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 00363 | Date 13/08/2018 |
| Token No | SM/24-25/16497 27/05/2024 | Serial | 003 |
| Patient Name | Mrs. LAXMI GHOSH | Contact No | 890271882 |
| Address | 25A/9 FIRINGI DANGA ROAD | Age | 55 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||