Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 04264 | Date 01/06/2023 |
| Token No | SM/22-23/11184 01/08/2023 | Serial | 025 |
| Patient Name | Mrs. PINKI MALI | Contact No | 6289931863 |
| Address | 8/A/2/26 GURUGARDEN ROAD PROVASHNAGAR SERAMPORE M 712249 | Age | 28 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||