Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 02640 | Date 06/09/2022 |
| Token No | SM/22-23/2518 06/09/2022 | Serial | 017 |
| Patient Name | Mrs. MIRA DEVI RAI | Contact No | 8585877849 |
| Address | 589 GHORAMARA PURBAPARA SERAMPORE 712203 | Age | 54 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 47 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||