Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01299 | Date 27/03/2020 |
| Token No | SM/22-23/1790 02/08/2022 | Serial | 006 |
| Patient Name | Mrs. MOUSUMI DAS | Contact No | 8925225853 |
| Address | 20/4/1 PRABASHNAGAR SERAMPORE 712249 | Age | 22 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||