Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 00807 | Date 25/01/2020 |
| Token No | SM/22-23/1995 12/08/2022 | Serial | 017 |
| Patient Name | Mrs. LAXMI MALAKAR | Contact No | 8697364267 |
| Address | 45 PRABASHNAGAR SERAMPORE 712249 | Age | 51 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 55 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||