Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 04337 | Date 16/06/2023 |
| Token No | SM/22-23/16802 21/12/2023 | Serial | 055 |
| Patient Name | Mrs. SURIYA NASRIN | Contact No | 8583974203 |
| Address | 31 A MD LANE SERAMPORE M 712203 | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||