Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00109 | Date 13/09/2019 |
| Token No | SM/22-23/3443 14/10/2022 | Serial | 012 |
| Patient Name | Mrs. BINA SHAW | Contact No | 9804669250 |
| Address | GHORAMARA PURBAPARA SERAMPORE 712203 | Age | 50 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 69 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||