Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05416 | Date 12/10/2023 |
| Token No | SM/22-23/14321 12/10/2023 | Serial | 037 |
| Patient Name | Mrs. SUSHAMA MALI | Contact No | 8481878805 |
| Address | GHORAMARA PURBAPARA MALLICKPARA SERAMPORE 712203 | Age | 33 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | 59 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||