Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03182 | Date 18/11/2022 |
| Token No | SM/22-23/4527 18/11/2022 | Serial | 020 |
| Patient Name | Mrs. MADHUMITA MONDAL | Contact No | 9051781184 |
| Address | UTTAR MONDAL PARA SIMLA MALLICKPARA 712203 | Age | 39 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 46 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||