Ticket for Outdoor Patient
| Ward No. 29 | U-PHC No. | Registration No. 02676 | Date 09/09/2022 |
| Token No | SM/22-23/2633 09/09/2022 | Serial | 040 |
| Patient Name | Mrs. KUSMA DEVI | Contact No | 9830551518 |
| Address | 120/B GURU GARDEN ROAD PRABASHNAGAR SERAMPORE 712249 | Age | 61 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||