Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 05221 | Date 23/09/2023 |
| Token No | SM/22-23/14106 09/10/2023 | Serial | 026 |
| Patient Name | Mrs. SANJANA PASWAN DOLUI | Contact No | 9830853115 |
| Address | 3/A B B GHOSH ROAD MALLICKPARA SERAMPORE 712203 | Age | 29 YRS Female |
| Token For | Visit Doctor,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||