Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 02904 | Date 15/10/2022 |
| Token No | SM/22-23/3496 15/10/2022 | Serial | 030 |
| Patient Name | Mrs. MAMPI BISWAS | Contact No | 7044185805 |
| Address | 502 G T ROAD MALLICKPARA SERAMPORE 712203 | Age | 33 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||