Ticket for Outdoor Patient
| Ward No. 26 | U-PHC No. | Registration No. 01613 | Date 23/05/2022 |
| Token No | SM/22-23/32 23/05/2022 | Serial | 001 |
| Patient Name | Mrs. MALA SINGH | Contact No | 9073565411 |
| Address | 21 BARAL BAGAN LANE SERAMPORE 712201 | Age | 49 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||