Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 07767 | Date 22/11/2022 |
| Token No | SM/24-25/16855 13/06/2024 | Serial | 004 |
| Patient Name | Mrs. CHAPA MAITY | Contact No | 9163642743 |
| Address | 41 DR. NANILAL BHATTACHARJEE STREET | Age | 76 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||