Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 06077 | Date 13/06/2022 |
| Token No | SM/24-25/19363 21/10/2024 | Serial | 005 |
| Patient Name | Mrs. SHILPI CHOWDHURY | Contact No | 9123961060 |
| Address | 13 DEY STREET | Age | 25 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||