Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 05310 | Date 03/10/2023 |
| Token No | SM/22-23/13835 03/10/2023 | Serial | 008 |
| Patient Name | Mrs. RUPALI POLLEY | Contact No | 6291725498 |
| Address | A/2Y TARAPUKUR GOVT QUARTER SERAMPORE 712203 | Age | 32 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||