Ticket for Outdoor Patient
| Ward No. 19 | U-PHC No. | Registration No. 04191 | Date 17/05/2023 |
| Token No | SM/22-23/8909 17/05/2023 | Serial | 016 |
| Patient Name | Mrs. BANDANA MONDAL | Contact No | 8100830305 |
| Address | 88/B S K NAGAR RISHRA M PRABASHNAGAR 712249 | Age | 39 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||