Ticket for Outdoor Patient
| Ward No. 6 | U-PHC No. | Registration No. 03217 | Date 22/11/2022 |
| Token No | SM/22-23/4628 22/11/2022 | Serial | 018 |
| Patient Name | Mrs. MAMPI DAS | Contact No | 7044695946 |
| Address | 10/G HARIPARA LANE MALLICKPARA SERAMPORE 712203 | Age | 32 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 15 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||