Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 04834 | Date 16/08/2023 |
| Token No | SM/22-23/11870 16/08/2023 | Serial | 012 |
| Patient Name | Mrs. PANCHALI NAYEK | Contact No | 9330034695 |
| Address | D/174/Y TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 45 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||