Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05002 | Date 29/08/2023 |
| Token No | SM/22-23/12494 29/08/2023 | Serial | 029 |
| Patient Name | Mrs. SRIPARNA SHAW | Contact No | 6290244572 |
| Address | GHORAMARA P PURBAPARA SERAMPORE MALLICKPARA 712203 | Age | 31 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||