Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 02685 | Date 12/09/2022 |
| Token No | SM/22-23/2657 12/09/2022 | Serial | 010 |
| Patient Name | Mrs. GAYTRI BHUIYA | Contact No | 8585876226 |
| Address | HARIJAN QUARTER B B GHOSH ROAD SERAMPORE 712203 | Age | 23 YRS Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||