Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01205 | Date 17/03/2020 |
| Token No | SM/22-23/4571 19/11/2022 | Serial | 016 |
| Patient Name | Mrs. KAKON ROY | Contact No | 7980734174 |
| Address | GHORAMARA SERAMPORE 712203 | Age | 25 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||