Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 04085 | Date 25/04/2023 |
| Token No | SM/22-23/14071 07/10/2023 | Serial | 026 |
| Patient Name | Mrs. PIYALI DEY KARMAKAR | Contact No | 6290182150 |
| Address | 65/A KUMIR JALA 2ND BYE LANE SERAMPORE 712203 | Age | 34 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | 100/70 mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||