Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 04843 | Date 17/08/2023 |
| Token No | SM/22-23/11938 17/08/2023 | Serial | 021 |
| Patient Name | Mrs. CHAMPA ROY | Contact No | 8479939886 |
| Address | 123/2 RAJYADHARPUR GOVT COLONY SERAMPORE 712203 | Age | 40 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||