Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 02550 | Date 25/08/2022 |
| Token No | SM/22-23/2279 25/08/2022 | Serial | 011 |
| Patient Name | Mrs. MOUSUMI ROUTH | Contact No | 8910235701 |
| Address | SIMLA MALLICKPARA SERAMPORE 712203 | Age | 18 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | 40 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||