Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 02704 | Date 14/09/2022 |
| Token No | SM/22-23/2753 14/09/2022 | Serial | 045 |
| Patient Name | Mrs. RENU DEBI RAJBHAR | Contact No | |
| Address | CHAKLAPARA PRABASHNAGAR SERAMPORE 712249 | Age | 44 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||