Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 04609 | Date 26/07/2023 |
| Token No | SM/22-23/10959 26/07/2023 | Serial | 003 |
| Patient Name | Mrs. DOLY THAKURATA | Contact No | 8017973808 |
| Address | 21/A/5 TARA PUKUR LANE SERAMPORE MALLIKPARA 712203 | Age | 62 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||