Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 03186 | Date 18/11/2022 |
| Token No | SM/22-23/4543 18/11/2022 | Serial | 036 |
| Patient Name | Mrs. KUSUM DEBI | Contact No | 9804371556 |
| Address | CHAKLAPARA PRABASHNAGAR SERAMPORE 712249 | Age | 35 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 56 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||