Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01700 | Date 27/05/2022 |
| Token No | SM/22-23/152 27/05/2022 | Serial | 013 |
| Patient Name | Mrs. ANUMIKA MONDAL | Contact No | 9330179465 |
| Address | 97 X K GURU GARDEN ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 18 Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 35 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||