Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 01761 | Date 30/05/2022 |
| Token No | SM/22-23/3346 11/10/2022 | Serial | 015 |
| Patient Name | Mrs. MAMATA HATUI | Contact No | 9163719701 |
| Address | 38 SANIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 68 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||