Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 01678 | Date 25/05/2022 |
| Token No | SM/22-23/121 25/05/2022 | Serial | 033 |
| Patient Name | Mrs. MASURA KHATOON | Contact No | 8981110729 |
| Address | 2A MIYA JAN DARJI LANE SERAMPORE 712203 | Age | 62 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 50 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||