Ticket for Outdoor Patient
| Ward No. 5 | U-PHC No. | Registration No. 02750 | Date 22/09/2022 |
| Token No | SM/22-23/2992 24/09/2022 | Serial | 001 |
| Patient Name | Mrs. RITA DEBI MISHRA | Contact No | 9903244191 |
| Address | 65/A/18 F D ROADMALLICKPARA SERAMPORE 712203 | Age | 42 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 44 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||