Ticket for Outdoor Patient
| Ward No. 4 | U-PHC No. | Registration No. 04849 | Date 17/08/2023 |
| Token No | SM/22-23/11956 17/08/2023 | Serial | 039 |
| Patient Name | Mrs. BELA BANERJEE | Contact No | 9836905567 |
| Address | 18/C RAJA RAMMOHAN ROY SARANI SERAMPORE 712203 | Age | 66 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||