Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01612 | Date 20/05/2022 |
| Token No | SM/22-23/31 20/05/2022 | Serial | 029 |
| Patient Name | Mrs. MADHABILATA MALAKAR | Contact No | |
| Address | SUKANTA PALLY SERAMPORE 712203 | Age | 65 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||