Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 01043 | Date 22/02/2020 |
| Token No | SM/22-23/3112 28/09/2022 | Serial | 004 |
| Patient Name | Mrs. PRABHA RANI SIL | Contact No | 6291702581 |
| Address | 165/C PROVASNAGER WEST JANNAGAR ROAD 712249 | Age | 72 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||