Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04995 | Date 29/08/2023 |
| Token No | SM/22-23/12475 29/08/2023 | Serial | 010 |
| Patient Name | Mrs. LALITA BARIK | Contact No | 8420469266 |
| Address | 22/A MIAJAN DARJI LANE MALLICKPARA SERAMPORE 712203 | Age | 52 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||