Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 02553 | Date 25/08/2022 |
| Token No | SM/22-23/2289 25/08/2022 | Serial | 021 |
| Patient Name | Mrs. UMA MODAK | Contact No | 8777256524 |
| Address | 146/A 2 NO TARAPUKUR COLONY SERAMPORE 712203 | Age | 45 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||