Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 02910 | Date 17/10/2022 |
| Token No | SM/22-23/3512 17/10/2022 | Serial | 014 |
| Patient Name | Mrs. KAJAL CHAKRABORTY | Contact No | 8622080241 |
| Address | 31 TARAPUKUR LANE MALLICKPARA SERAMPORE 712203 | Age | 51 Female |
| Token For | Medicine,Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||