Ticket for Outdoor Patient
| Ward No. 28 | U-PHC No. | Registration No. 01780 | Date 01/06/2022 |
| Token No | SM/22-23/277 01/06/2022 | Serial | 005 |
| Patient Name | Mrs. LAXMI ADHIKARI | Contact No | 9163003251 |
| Address | 20 NO RAJYADHARPUR GOVT QUARTER SERAMPORE 712203 | Age | 35 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||