Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 02204 | Date 13/07/2022 |
| Token No | SM/22-23/1445 18/07/2022 | Serial | 068 |
| Patient Name | Mrs. LAZO SHAW | Contact No | |
| Address | NEW MAHESH KATAPULL SERAMPORE 712203 | Age | 35 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||